Republicans fear that a federal judge’s decision Friday striking down the Affordable Care Act will put them in a perilous political position and will hand Democrats a powerful line of attack for next Congress and the 2020 elections.

The ruling by U.S. District Judge Reed O’Connor in the Northern District of Texas strikes down the entirety of the Affordable Care Act, also known as Obamacare. The decision throws out a range of healthcare provisions, including rules that insurers must cover people with pre-existing conditions, the extension of the Medicaid program to the poor, and coverage for maternity care, mental health, and substance abuse disorders.