A federal judge in Texas struck down a key provision of the Affordable Care Act (ACA) that requires insurers and employers to cover preventive services for free, including cancer screenings. It immediately jeopardizes access to treatment for the approximately 100 million Americans who use free preventive services annually, and it leaves the door open for insurers to impose deductibles and copays for potentially life-saving screening tests. It is likely deter patients - particularly those of limited means - from scheduling mammograms, colonoscopies and other procedures.