Courts play a pivotal role in determining what health services American receive, and how they are paid for. That’s been apparent in the challenges to the Affordable Care Act and it will be evident as advocates respond to the restrictive new abortion laws being passed in multiple states. The judicial system is also deeply involved in decisions that affect commerce, many of which have profound clinical and ethical implications – such as whether genes can be patented. Some of these complex and controversial issues are likely to end up in the Supreme Court, but the journey there involves a series of interim steps. How are these health-related cases moving through the legal system and which ones are likely to be taken on by the Supreme Court?