The Supreme Court justices seem likely to uphold a key provision of the Affordable Care Act, also known as Obamacare, that requires insurers to cover certain preventive health services at no cost to patients.

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 case challenges the authority of a panel of health experts called the U.S. Preventive Services Task Force (USPSTF), part of the Department of Health and Human Services (HHS), recommending the type of preventive services that should be covered for free.

Plaintiffs argued the rules from USPSTF should not count because the members were not properly appointed under the U.S. Constitution. The challengers have also raised religious and procedural objections to some requirements.

The Justice Department defended board members, saying they don’t need Senate approval because they can be removed by Health and Human Services Secretary Robert F. Kennedy Jr.

A majority of the justices seemed inclined to side with the government, including conservative justices Brett Kavanaugh and Amy Coney Barrett, along with three liberal justices.

Kavanaugh said on Monday he didn’t see indications in the law that the board of health experts was designed to have the kind of independent power requiring Senate approval. Amy Coney 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,” Justice Elena Kagan said about the court’s prior opinions.

Justices Samuel Alito and Clarence Thomas seem likely to side with the plaintiffs. Some experts suggested the high court could return the case to the conservative U.S. 5th Circuit Court of Appeals. That decision would likely leave unanswered questions about which medications and services remain covered.

A ruling is expected by the end of June.

Editor’s note: Associated Press contributed to this article.

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