Braidwood Mgmt v. Becerra, 104 F.4th 930

Plaintiffs (individuals and Christian-run businesses) challenged the Affordable Care Act's (ACA) preventive-care mandates requiring insurance coverage of certain services (e.g., contraception, PrEP for HIV) on religious and constitutional grounds.
The main claim was that the entities responsible for issuing the recommendations (the U.S. Preventive Services Task Force, ACIP, and HRSA) violated the Constitution's Appointments Clause, as members were not properly appointed as principal officers.
The district court largely sided with plaintiffs, invalidating agency actions enforcing the Task Force mandates and granting both plaintiff-specific and universal (nationwide) injunctive relief.
The government appealed, asserting the bodies were lawfully constituted and remedies were overly broad; plaintiffs cross-appealed, continuing their Appointments Clause challenge to ACIP and HRSA.
On appeal, the Fifth Circuit affirmed the holding that the Task Force members are principal officers not properly appointed, reversed the universal/nationwide relief, and remanded further issues for proceedings below.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Are Task Force members principal officers requiring President/Senate appointment?	Yes; they exercise significant authority without oversight.	No; Secretary has removal and supervisory power.	Task Force members are principal officers; their appointment violates Article II.
Does ratification by the HHS Secretary cure the Appointment Clause defect?	No; Secretary lacks statutory power to review or issue recommendations.	Yes; Secretary can cure via ratification memo of all recommendations.	Ratification is ineffective; Secretary lacks authority to ratify Task Force acts.
Was the district court's universal (nationwide) injunction and vacatur proper?	Yes; such relief needed to remedy harm and is proper under APA.	No; relief should be limited to parties, especially with no APA claim.	Universal relief was improper; only party-specific relief affirmed.
Do ACIP/HRSA violate the Appointments Clause?	Yes; similar defect as Task Force—they act without proper appointment.	No; HHS Secretary can supervise and ratify their actions.	Remanded for consideration of APA/process issues with Secretary’s ratification.

Buckley v. Valeo, 424 U.S. 1 (principal/inferior officer distinction under Appointments Clause)
Morrison v. Olson, 487 U.S. 654 (Appointments Clause, factors distinguishing principal/inferior officers)
Edmond v. United States, 520 U.S. 651 (importance of supervision in inferior officer analysis)
Free Enter. Fund v. Public Co. Acct. Oversight Bd., 561 U.S. 477 (removability and oversight as key to inferior status)
United States v. Arthrex, Inc., 594 U.S. 1 (officer making final decisions without review is principal officer)
Califano v. Yamasaki, 442 U.S. 682 (injunctive relief must be no broader than necessary)
Trump v. Hawaii, 585 U.S. 667 (skepticism of federal universal/nationwide injunctions)
United States v. Texas, 599 U.S. 670 (limits of relief in administrative law)