WASHINGTON (AP) — The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.
Conservative justices Brett Kavanaugh and Amy Coney Barrett, along with the court's three liberals, appeared skeptical of arguments that Obamacare's process for deciding which services must be fully covered by private insurance is unconstitutional.
The case could have big ramifications for the law's preventive care coverage requirements for an estimated 150 million Americans. Medications and services that could be affected include statins to prevent heart disease, lung cancer screenings, HIV-prevention drugs and medication to lower the chance of breast cancer for high-risk women.
The plaintiffs argued that requirements to cover those medications and services are unconstitutional because a volunteer board of medical experts that recommended them should have been Senate- approved. The challengers have also raised religious and procedural objections to some requirements.
The Trump administration defended the mandate before the court, though President Donald Trump has been a critic of the law. The Justice Department said board members don’t need Senate approval because they can be removed by the health and human services secretary.
A majority of the justices seemed inclined to side with the government. Kavanaugh said he didn't see indications in the law that the board was designed to have the kind of independent power that would require Senate approval, and Barrett questioned the plaintiff's apparently “maximalist" interpretation of the board's role.
“We don’t just go around creating independent agencies. More often, we destroy independent agencies,” said Justice Elena Kagan said about the court's prior opinions.
Justices Samuel Alito and Clarence Thomas seemed likely to side with the plaintiffs. And some suggested they could send the case back to the conservative U.S. 5th Circuit Court of Appeals. That would likely leave unanswered questions about which medications and services remain covered.
A ruling is expected by the end of June.
The case came before the Supreme Court after the appeals court struck down some preventive care coverage requirements. It sided with Christian employers and Texas residents who argued they can’t be forced to provide full insurance coverage for things like medication to prevent HIV and some cancer screenings.
They were represented by well-known conservative attorney Jonathan Mitchell, who represented Trump before the high court in a dispute about whether he could appear on the 2024 ballot.
Not all preventive care was threatened by the ruling. A 2023 analysis prepared by the nonprofit KFF found that some screenings, including mammography and cervical cancer screening, would still be covered without out-of-pocket costs.
The appeals court found that coverage requirements were unconstitutional because they came from a body — the United States Preventive Services Task Force — whose members were not nominated by the president and confirmed by the Senate.
FILE - The Supreme Court is seen on Capitol Hill in Washington, Dec. 17, 2024. (AP Photo/J. Scott Applewhite, File)
SANTA CLARA, Calif. (AP) — The San Francisco 49ers are opening the practice window for star linebacker Fred Warner with the hope that he could return if the team reaches the NFC title game.
Warner has been out since breaking and dislocating his right ankle in a loss at Tampa Bay on Oct. 12, with coach Kyle Shanahan initially describing it as a season-ending injury.
But Warner has been rehabbing since then and even was able to run on a side field last week during practice. Now he will be back officially at practice as the 49ers prepare to play Seattle in the divisional round on Saturday night and could return if San Francisco wins.
“We’re not doing much so he’ll walk through out there with us today and things like that, but hoping he can be ready for next week,” Shanahan said Tuesday.
Warner's presence on the practice field even for a walkthrough provided an emotional lift for the 49ers.
“For someone who really set the standard here, I would do anything to play with him again this year,” defensive tackle Kalia Davis said. “We want him back out there.”
Eric Kendricks is currently manning Warner's spot at middle linebacker after backup Tatum Bethune got hurt but wasn't ready to talk about what Warner's possible return would do for the team.
“We’re aren’t going to talk about next week, right? We’ve got Seattle,” Kendricks said. “We’ve got to beat Seattle. Let’s pump our brakes. We have to beat Seattle this week. .. This is what meaningful football is all about.”
The 49ers have made it this far despite losing their top two defensive players to injuries early in the season, with defensive end Nick Bosa going down with a season-ending knee injury in Week 3 and Warner getting hurt in Week 6.
Warner has been pushing to make a return and if he can, that would provide a needed boost. But Shanahan said the final decision will be in the hands of the team doctors.
“If he feels good and tells me he’s good, I’m probably going to think he is and trust him to get out there,” Shanahan said. “But you can't always think with your heart and emotionally. So you ask doctors where he’s at, all the things that these guys have to pass, just protocols that we have in with just sprinting and jumping and things like that. He’s got to hit all those before we feel it’s safe.”
But Shanahan added that as soon as the doctors clear Warner, "obviously it’ll be zero decision on my part.”
Warner had been a first-team All-Pro three straight seasons from 2022-24 and made the squad in 2020. His 947 career tackles are the second most for the team, behind Patrick Willis’ 950, as far as records go back to 2000.
Warner had missed only one game in his eight-year career before this injury, sitting out in 2021 with a hamstring injury. He played most of last season with a broken bone in his ankle and still earned All-Pro honors.
Warner signed a three-year extension worth $63 million in the offseason, keeping him under contract with the team through the 2029 season.
In other injury news, safety Ji'Ayir Brown (hamstring) and Luke Gifford (quadriceps) all would have been unable to practice had the team held a session. Receiver Ricky Pearsall (knee), linebacker Dee Winters (ankle), guard Dominick Puni (ankle) and defensive lineman Keion White (groin, hamstring) all would have been limited.
Shanahan also said tight end George Kittle is set to have surgery on his ruptured Achilles tendon on Wednesday. Kittle went on injured reserve Tuesday and tight end Brayden Willis was signed from the practice squad.
AP NFL: https://apnews.com/hub/nfl
FILE - San Francisco 49ers middle linebacker Fred Warner is carted off the field during the first half of an NFL football game against the Tampa Bay Buccaneers in Tampa, Fla., Oct. 12, 2025. (AP Photo/Jason Behnken, File)
FILE - San Francisco 49ers middle linebacker Fred Warner (54) runs to the locker room after pregame warm-ups before an NFL football game against the Tampa Bay Buccaneers on Oct 12, 2025, in Tampa, Fla. (AP Photo/Peter Joneleit, File)
