NEJM Interview: Elizabeth Kaplan on changes to the U.S. Preventive Services Task Force and the importance of evidence-based recommendations for preventive services.

In May 2026, Secretary of Health and Human Services Robert F. Kennedy Jr. fired two members of the US Preventive Services Task Force. That move followed a June 2025 Supreme Court decision confirming that the secretary has significant power over the task force. I'm Stephen Morrissey, Managing Editor of the New England Journal of Medicine, and I'm talking with Elizabeth Kaplan, a clinical instructor and Director of Healthcare Access at the Center for Health Law and Policy Innovation at Harvard Law School. Ms. Kaplan has co-authored a perspective article about changes to the USPSTF and related policies. Ms. Kaplan, broadly, what are the responsibilities of the USPSTF, and who serves on that body?

The responsibilities of the USPSTF are to review scientific literature and evidence regarding preventive services that are available for particular populations and to assess benefits and potential drawbacks of those preventive services based on the evidence and to make recommendations for individuals as to what preventive services would serve their long-term health benefits. As to who serves on the task force, these are providers with expertise in primary care, obstetrics and gynecology, preventive medicine, and I believe also, in some instances, pediatrics. And they are volunteers serving in a capacity where they are appointed to serve on the task force for a period of years, but they're bringing their expertise in providing and recommending preventive services to patient populations that they serve.

And then how did the Supreme Court's decision in Kennedy v. Braidwood Management clarify the role of these USPSTF members and the secretary's authority over the task force and its recommendations?

So the US Supreme Court was presented with a constitutional question as to whether the members of the task force are appointed and serve in their positions in a capacity that's consistent with the Appointments Clause of the US Constitution. And that clause requires that principal officers of the federal government must be appointed by the president and confirmed to their positions by the Senate. And usually when we think of principal officers, we're thinking of people such as secretaries of cabinet and people with that level of authority. So the Supreme Court was presented with the suggestion or the argument that the members of the USPSTF are unconstitutionally appointed because rather than being appointed by the president and confirmed by the Senate, they are simply appointed by the Secretary of HHS without a confirmation procedure and without the president's involvement. And the argument goes that they are principal officers because they were not sufficiently supervised by another official who is appointed consistent with the process outlined in the Appointments Clause. The Supreme Court looked at that argument and concluded that, in fact, the members of the USPSTF are not principal officers under the US Constitution. They are, in fact, inferior officers because they are supervised by the Secretary of HHS, who is himself appointed consistent with the clause. And the positive effect of all this is to say that the appointment of the members of the USPSTF is