Democrats may hate the substance of yesterday's court ruling striking down elements of the Affordable Care Act — this time, its requirement that employers cover certain preventative care services.

• But politically, it feeds right into the party's 2024 campaign playbook, Axios' Caitlin Owens writes.

Why it matters: Defending the ACA has been a tried-and-true strategy for Democrats since the GOP tried to repeal it in 2017. Judicial threats to the law easily fold into messaging about right-wing extremist judges that the party has been building on since the Supreme Court overturned the federal right to abortion.

• And while Republicans may still not be huge fans of the law, its preventative care provisions weren't exactly topping their list of grievances.

Driving the news: Yesterday's decision — written by the same federal judge in Texas who ruled the entire law invalid — essentially forces employers and insurers to decide whether to continue covering certain preventative benefits without cost-sharing.

• America's Health Insurance Plans, insurers' top lobbying group, said in a statement that "Americans should have peace of mind there will be no immediate disruption in care or coverage."
• "We fully expect that this matter will continue on appeal, and we await the federal government's next steps in the litigation, as well as any guidance from relevant federal agencies," AHIP added.

The big picture: A court ruling that could eliminate nationwide access to a common abortion pill could be imminent. If FDA approval of the drug is overturned, Democrats would have even more fodder for their argument.

The bottom line: The ruling puts Democrats in a familiar and comfortable position and will likely force Republicans to once again answer for a politically unpopular court decision.

• "It's another real health care take-away threat that may actually be an unwelcome ruling in some Republican political circles," said Democratic strategist Chris Jennings.

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Thursday's ACA court ruling won't bring a seismic shift to employer-sponsored health care.

• But experts say it could well add new costs for the approximately 100 million privately insured people who use ACA-covered preventive services.

Between the lines: In the short term, most large employers won't be racing to make changes by the next coverage year as they wait to see how the legal challenge to coverage requirements plays out in the courts.

• That's in part because insurance companies have to submit rate filings and submit to regulatory reviews, Garrett Hohimer, vice president for policy and advocacy for the Business Group on Health, told Axios.

But even longer-term, Hohimer said he also doesn't expect a "wholesale abandonment" of coverage of preventative services, no matter what happens with this case, because insurers and large employers have seen their financial upside.

• "Preventative services have clearly helped avoid the need for more involved, more expensive coverage down the line and improve health and well-being currently and in the future," he said.

Yes, but: Insurers and employers could start shifting the cost of some services. That's no small matter in the case of a CT scan for lung cancer. And it's possible that coverage may return to the pre-ACA patchwork as carriers adjust.

• While many employers will still want to buy plans that pay for preventative services up front, "there are lots of employers who struggle to pay for health insurance as it is, so if this means savings for them, they're probably going to want to take that savings," said Michael Botta, a health economist and co-founder of Sesame, a direct-to-patient care company.

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Five conservative-led states will begin the culling their Medicaid rolls this weekend, kicking off a process that could lead to nearly 15 million people losing coverage over the next year, Axios' Arielle Dreher writes.

Why it matters: The looming end to the public health emergency means states are no longer required to keep people on the safety net program in exchange for enhanced federal funds.

• Biden administration officials have expressed concerns about people who are still eligible for health coverage getting cut out, because they're not aware eligibility is being redetermined when a state agency cannot reach them.

Driving the news: Arkansas, Arizona, Idaho, New Hampshire and South Dakota will begin terminations in April, per data from the Centers for Medicare and Medicaid Services.

• The majority of states are expected to follow suit this summer, beginning terminations between May and July.

Go deeper ... How to renew your coverage.

A Medicare Advantage lobbying group that's emerged as the biggest political ad spender this year appears focused on prodding endangered Democratic incumbents in battleground states to turn back a package of Biden administration policy changes, Axios' Maya Goldman writes.

• Better Medicare Alliance spent $13.5 million on media spots through March 31, according to data collected by AdImpact and shared with Axios. The group declined to comment.

Why it matters: The blitz comes as the Biden administration seeks to change elements of the way private Medicare plans get paid.

• The organization's ads portray the proposal as a cut Medicare that would hurt seniors.
• Yes, but: The Biden administration disputes the characterization and maintains the changes will make payments to insurers more accurate.

What we're watching: The next turn comes on or before Monday afternoon, when CMS is due to release the final Medicare Advantage payment notice for 2024.

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Meet Neville, an 8-month-old Staffordshire Bull Terrier who lives in San Diego.

• "He's been my personal heater during the extra cold [California] winter this year because he loves to cuddle with his humans, or anyone actually!" writes his human, Jennifer Donahue.