Does the appointment of members of the U.S. Preventive Services Task Force by the Secretary of Health and Human Services (HHS) comply with the Appointments Clause of Article II of the Constitution? This determination depends on whether these members are "principal officers," requiring Presidential nomination and Senate confirmation, or "inferior officers," who may be appointed by a department head. The Court must also determine if Congress legally vested the appointment authority in the Secretary of HHS.

• Task Force members are inferior officers because they are removable at will and their recommendations are reviewable by the Secretary before taking effect.
• The Secretary’s power to remove members provides a "powerful tool for control" that ensures supervision and direction.
• Appointment authority was vested in the Secretary through 42 U.S.C. § 299b-4(a)(1), which allows the AHRQ Director to "convene" the Task Force, and Reorganization Plan No. 3 of 1966, which transferred all functions of Public Health Service officers to the Secretary.
• The statutory requirement that members be "independent" does not create for-cause removal protection or insulate them from secretarial review.

• Task Force members are principal officers because they have no superior who supervises and directs them, meaning they must be appointed by the President with Senate advice and consent.
• The requirement in 42 U.S.C. § 299b-4(a)(6) that members be "independent and, to the extent practicable, not subject to political pressure" precludes supervision by a political appointee like the Secretary.
• The term "convene" in 42 U.S.C. § 299b-4(a)(1) is agnostic regarding appointment authority and does not confer the power to appoint members.
• Reorganization Plan No. 3 of 1966 only transferred functions existing as of 1966 and does not transfer appointment powers granted by later statutes.

• Task Force members are inferior officers because their work is "directed and supervised" by the Secretary of HHS, a principal officer, applying the test from *Edmond v. United States*.
• The Secretary's authority to remove members at will constitutes a "powerful tool for control," creating "here-and-now subservience" as noted in *Bowsher v. Synar* and *Edmond*.
• The Secretary possesses statutory authority to review and block recommendations before they take effect, meaning members cannot render a final decision on behalf of the United States without the Secretary's permission (*Edmond*).
• This supervisory power is derived from 42 U.S.C. § 202 (general supervision of Public Health Service), Reorganization Plan No. 3 of 1966, and 42 U.S.C. § 300gg-92 (rulemaking authority for the Affordable Care Act).
• The Court rejected the argument that 42 U.S.C. § 299b-4(a)(6)'s "independence" provision creates for-cause removal protection, citing *Collins v. Yellen* and *Shurtleff v. United States*.
• Appointment authority was vested in the Secretary via a two-step process: first, 42 U.S.C. § 299b-4(a)(1) authorized the AHRQ Director to "convene" (read as appoint) the Task Force; second, Reorganization Plan No. 3 of 1966 transferred all such functions to the Secretary.
• The Court applied the canon of constitutional avoidance to interpret the statutes in a way that avoids rendering the appointment process unconstitutional (*Edmond*).