The latest case out of Texas and the US Fifth Circuit Court of Appeals to threaten vital public health policies is Braidwood Management Inc v Becerra.1 The Braidwood plaintiffs seek to end the Patient Protection and Affordable Care Act (ACA) requirement that insurance plans cover a range of recommended preventive services without cost-sharing. The Fifth Circuit called its June 2024 decision in this case 鈥渁 mixed bag鈥� in that it ruled in favor of the plaintiffs but limited the influence of the case to just the parties who sued and did not reshape private health insurance nationwide.2