Yesterday Virginia federal judge Henry Hudson ruled in a case filed in March by Virginia Attorney General Ken Cuccinelli that the Minimum Essential Coverage Provision of the Patient Protection and Affordable Care Act (ACA) is unconstitutional. The provision requires that all US citizens obtain health insurance coverage beginning in 2014. The provision has previously been challenged and found constitutional by another court in Virginia and one in Michigan. Judge Hudson’s ruling is the first to find the provision unconstitutional. Attorney General Eric Holder and Secretary of Health and Human Services Kathleen Sebelius stated in their joint op-ed, “Every insured family pays an average of $1,000 more a year in premiums to cover the care of those who have no insurance…Striking down the individual responsibility provision means slamming the door on millions of Americans, who’ve been locked out of our health insurance markets, and shifting more costs onto families who’ve acted responsibly.” Under the ACA, certain preventive procedures, such as mammograms, colonoscopies, pap smears, tobacco cessation services, and obesity prevention services, no longer require a co-payment or other direct costs. President Obama signed the final version of the Affordable Care Act in March. The final law will eventually add coverage for 32 million people, increasing access to family planning and preventive care.