Michael Hiltzik of the Los Angeles Times is an extraordinary opinion writer. I subscribe to the LA Times, and I always look forward to his cogent insights. In this one, he describes the tactics of rightwing lawyers, who shop for rightwing judges. When they wanted to invalidate a key plank in Obamacare, they knew exactly where to go to find a zealot to take away free preventive care from all Americans. If not reversed, this decision will cost hundreds of thousands of lives–by denying access to early screenings for cancer and other deadly diseases.

Hiltzik writes:

You might have thought that, more than a dozen years after its enactment, the Affordable Care Act was finally safe from interference by right-wing judges carrying water for religious fanatics and anti-government activists.

Unfortunately, a ruling from a one-horse federal courtroom in Texas reminds us that there’s almost an endless supply of those litigants and the judges who run with them. Less than two weeks ago, U.S. Judge Reed O’Connor invalidated an ACA provision mandating that a long list of preventive care services be provided to patients without co-pays or deductibles.

If O’Connor’s March 30 ruling stands (the government is certain to appeal), it would block no-fee preventive services such as breast- and cervical-cancer screenings for millions of women, smoking cessation programs, hepatitis tests, screening for diabetes, osteoporosis, depression, HIV and many other conditions and health risks.

A court oversteps its authority when an injunction does more than benefit the plaintiffs who have sued.

— Law professors Nicholas Bagley and Samuel Bray

The anti-HIV provision, as it happens, was the principal target of the plaintiffs in this case. Among them are Steven Hotze, a self-described Christian owner of a “wellness” center who complained that the Affordable Care Act mandate to provide anti-HIV drugs would “facilitate behaviors such as homosexual sodomy, prostitution, and intravenous drug use — all of which are contrary to Dr. Hotze’s sincere religious beliefs.”

Hotze also objects to other preventive-care mandates that require his business’ health plans to cover screening for and counseling about sexually transmitted diseases “for those engaged in non-marital sexual behavior.”

O’Connor’s ruling undermines one of the bedrock public-health features of the Affordable Care Act, its encouragement of services aimed at keeping Americans healthy by catching signs of developing medical issues before they require costly interventions.

Sadly, the ruling didn’t come as much of a surprise: Not only did O’Connor telegraph his decision during hearings on the lawsuit months ago, but he’s the same judge who in 2018 tried to throw a monkey wrench into Obamacare by declaring the entire law unconstitutional.

The Supreme Court slapped him down with a 7-2 ruling upholding the act’s constitutionality in 2021, but that didn’t seem to invest O’Connor with any measure of humility.

O’Connor’s latest ruling underscores a major problem with America’s federal judicial system. That’s the ability of hack judges in backwater courthouses to interfere with policy by issuing nationwide injunctions based on specious or at least shallow legal arguments.

In time, we will see whether the Trump Supreme Court agrees that Americans don’t need preventive health care.