On Monday, the Supreme Court heard oral arguments in a case that could lead health insurance plans to offer narrower coverage. The case, known as Kennedy v. Braidwood Management, challenges the authority of a group within the US Department of Health and Human Services tasked with requiring insurers to cover some forms of preventative care.

This body, known as the US Preventive Services Task Force (PSTF), has exercised its authority to mandate coverage of a wide range of treatments — from cancer screenings, to drugs that prevent transmission of the HIV virus, to eye ointments that prevent infections that cause blindness in infants. Notably, the PSTF was given this power by the Affordable Care Act, the landmark legislation signed by President Barack Obama, which Republican litigants frequently ask the courts to undermine.

The plaintiffs, represented by former Donald Trump lawyer Jonathan Mitchell, want the justices to strip the PSTF of this authority — thus permitting health plans to deny coverage for treatments they are currently required to pay for.

Based on Monday’s argument, it does not appear likely that Mitchell has the votes for that outcome. Justices Clarence Thomas and Samuel Alito came out swinging against the PSTF, and Justice Neil Gorsuch appeared likely to join them in attempting to sabotage Obamacare. But they were the only three justices who clearly telegraphed sympathy to Mitchell’s arguments.

Notably, Republican Justices Brett Kavanaugh and Amy Coney Barrett both seemed inclined to vote against Mitchell, although their questions did leave some uncertainty about how they would ultimately rule in this case. All three of the Court’s Democrats appeared all but certain to uphold the PSTF, so that means there may be at least five votes to preserve health insurers’ obligations under Obamacare.

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