Will the Supreme Court Case on Obamacare Expand RFK Jr’s Power Over Public Health?

How a legal defense of the Affordable Care Act could shift more control to an unlikely player

What Is This Supreme Court Case About and Why Does It Matter?

Former President Donald Trump’s administration famously opposed the Affordable Care Act (ACA), also known as Obamacare. Yet in a surprising turn, his current Justice Department is now defending a key provision of the law before the Supreme Court. The case focuses on whether the federal government can continue requiring insurance companies to cover certain preventive health services at no cost to patients—an issue that affects over 150 million Americans.

The case stems from a challenge by conservative groups arguing that the U.S. Preventive Services Task Force (USPSTF), a panel of independent experts, wields too much unchecked power by setting which preventive services must be covered without patient cost-sharing.

If the court rules in favor of the federal government, not only will these zero-cost screenings and preventive benefits remain intact, but Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. could suddenly gain more control over the task force itself, and possibly over broader public health policy.

How Did RFK Jr. Become a Central Figure in the ACA Conversation?

Once a vaccine skeptic with a libertarian streak, RFK Jr. now leads the U.S. Department of Health and Human Services under Trump’s second term. His tenure has already sparked headlines with plans to restructure HHS, including layoffs and a new $20 billion "Administration for a Healthy America" designed to centralize health-related authority.

He has also raised questions about the validity of long-standing public health guidelines—many of which are set by the USPSTF. If the Supreme Court upholds the ACA mandates, it may ironically give Kennedy more control over an expert body he has often critiqued.

As of 2025, nearly 167 million people rely on ACA-related preventive care provisions for free access to mammograms, colon cancer screenings, HIV prevention pills (PrEP), and more, according to data from KFF.

What Could This Mean for Preventive Health Services?

This case isn’t just a legal footnote—it could reshape how preventive care is defined and who gets to define it. A ruling in favor of the federal government might:

• Cement the USPSTF’s authority

• Allow HHS, now led by Kennedy, to play a larger role in shaping those guidelines

• Shift the political narrative around the ACA.

Interestingly, Trump’s defense of the ACA is a pivot from his past rhetoric, suggesting that public demand for popular provisions like free cancer screenings has outlasted party lines.

A 2023 Pew Research study found that 57% of Americans support keeping the ACA in place, even if they disagree on other healthcare issues. The ACA provision in question affects most employer-sponsored health plans, Medicare, and the ACA exchange markets.

Could RFK Jr. Use This Win to Change Public Health Guidelines?

It’s possible. If the HHS Secretary is granted broader influence over the USPSTF or is allowed to bypass it in the future, Kennedy could push for or against services based on his unorthodox views. That could include:

• Reevaluating vaccine recommendations

• Slowing the adoption of new preventive care guidelines

• Reorienting public health messaging to reflect his populist base

This would effectively give RFK Jr. more direct sway over what insurers must cover, shifting power from independent panels to political appointees.

And that’s where things get tricky. Public health experts worry that such moves could undermine evidence-based decision-making. Former CDC director Dr. Tom Frieden recently warned:

“Once public health recommendations are shaped by politics rather than science, we all lose.”

What’s the Bigger Picture?

The ACA's legal challenges never really ended—they’ve just shifted forms. This time, it's not about killing the law. It’s about who controls its levers.

If this case ends with the Supreme Court reaffirming the preventive service mandate, millions of Americans keep their free screenings—but RFK Jr. may gain greater influence over what counts as “preventive” in the first place.

With plans to consolidate HHS power under a new bureaucracy and with staffing upheavals already underway, this ruling could be the starting point of a much larger transformation.

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Medical Disclaimer

The information provided in this article is for educational and informational purposes only and is not intended as medical advice. It should not be used to diagnose, treat, cure, or prevent any medical or mental health condition. Always seek the guidance of a qualified healthcare professional or licensed mental health provider with any questions you may have regarding a medical condition, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have read here.