Lawyers relying on the Affordable Care Act to mitigate their client’s liability in medical malpractice cases have been dealt a series of setbacks in state and federal courts amid concerns Congress will repeal the law.

A Pennsylvania federal judge recently blocked a hospital from doing just such a thing, marking the third time a court in the region has reached a similar decision. U.S. District Judge Kim R. Gibson of the Western District of Pennsylvania’s decision in Nicole Welker’s case against Clearfield Hospital and Dr. Thomas A. Carnevale disallowed the defendants from calculating future medical expenses with the ACA as part of the equation. The ruling came three days after the inauguration of President Donald Trump.

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