Journal of the American Medical Association  |  April 10, 2023

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The same federal judge in Texas who struck down the entire Affordable Care Act (ACA) in 2018 (which was later reversed by the US Supreme Court) has now invalidated a core protection of the law: cost-free preventive care. These services range from cancer screening to pregnancy care and have benefited more than 150 million US residents of all backgrounds, improved health outcomes, and helped reduce disparities. Like previous attempts to undercut the ACA, this one stems from a continuing desire to dismantle the law, stifle administrative agencies, and undermine Congress’ authority to design federal programs. It also stems from animus toward LGBTQ+ individuals and those with substance use disorder.


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