Yesterday, the Supreme Court heard oral arguments in Kennedy v. Braidwood Management, which could upend the Affordable Care Act (ACA)’s preventive care requirements as we know them. The case is, on its face, about separation of powers and the delegation of authority around preventive health services under the ACA. But like every challenge conservatives launch against the ACA, it is about so much more.

Here’s how we know that the ACA is a landmark legislative achievement—aka, that bitch. Conservatives have spent more than a dozen years pitching every harebrained legal theory they have to challenge it, only to lose time and time again, with notable carve outs the Court allowed around the birth control benefit for certain employers. This latest challenge—brought by one of the ghouls behind Texas’ notorious abortion bounty-hunter bill, SB 8—seems likely to suffer the same fate.

The ACA requires health insurers and group health plans to cover “preventive health services” at no additional cost to the patient. Those services are determined by the U.S. Preventive Services Task Force (PSTF), a group of 16 volunteer experts in their fields, who recommend which health services should be considered preventive care under the ACA. The Public Health Service Act mandates task force members and their work to be independent and free of “political pressure.” The task force’s recommendations for required preventive-care services include coverage for cancer screenings and pre-exposure prophylaxis (PrEP), the drug that prevents HIV transmission.

The task force, and its origins and structure, had operated largely unchallenged by conservatives since the ACA’s passage and despite all their other complaints about the ACA. But then, the first Trump administration successfully packed the federal courts........

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