On July 9, President Donald J. Trump nominated D.C. Court of Appeals Judge Brett Kavanaugh to be the next justice of the U.S. Supreme Court. His public record of previous decisions and statements sheds light on the impact that Kavanaugh’s appointment could have on the nation’s health. To help senators and the public evaluate the nominee, the American Public Health Association recently published a full assessment of the judge’s past rulings and views on key public health issues, including reproductive rights, gun violence, the Affordable Care Act and more. Here’s a summary of key findings from APHA’s brief.

Access to care

The Affordable Care Act has quickly become a focus of Kavanaugh’s confirmation hearings. Although Kavanaugh’s previous statements and rulings related to the law are somewhat ambiguous, he helped lay the groundwork for the Supreme Court to uphold the ACA’s constitutionality with the suggestion that the individual mandate could be a tax instead of a penalty. However, he has also asserted that the president could decide not to enforce the law, even if the court upholds its constitutionality.

The Supreme Court nominee’s beliefs about the constitutionality of the ACA are of particular concern because of a pending lawsuit in Texas. In this case, a group of 20 conservative states argue that Congress’ repeal of the individual mandate renders other provisions of the ACA unconstitutional, including protections for people with pre-existing conditions. If the lawsuit comes before the Supreme Court, his opinion on the law’s constitutionality may have a significant impact.

Reproductive health

Kavanaugh’s views related to reproductive rights, however, are more clear. He has repeatedly demonstrated that he would not uphold protections for access to abortion and contraception. He has applauded comments that denounce the decision made in Roe v. Wade, claiming that it established a right that is not “rooted in the nation’s history and tradition.”

Kavanaugh has also expressed that he views adherence to legal precedent as a flexible concept, opening the door to the reversal of important reproductive rights decisions. In a more recent case, Kavanaugh dissented from the decision to grant an undocumented teenager timely access to an abortion, claiming that she did not have the right to “abortion on demand.” He has also argued that organizations with religious objections should not have to offer contraception coverage.

Environment and gun violence prevention

Kavanaugh’s appointment to the Supreme Court could also jeopardize environmental health issues and gun violence prevention. Kavanaugh has repeatedly ruled against the U.S. Environmental Protection Agency and its efforts to limit pollution, claiming that the agency exceeded its authority. These cases include EPA policies to regulate air pollution across state lines, fine the improper shipment of hazardous chemicals and ban certain uses of greenhouse-gas-producing hydrofluorocarbons.

In a case that challenged the constitutionality of Washington, D.C.’s, ban on assault weapons and high-capacity magazines, Kavanaugh argued that there is no meaningful distinction between semi-automatic handguns and semi-automatic rifles. In his dissenting opinion, he argued that a ban on assault weapons is unconstitutional because they are in common use by law-abiding citizens. These cases represent only some of Kavanaugh’s record, but throw into question his alignment with public health values and priorities.

The appointment of the next Supreme Court justice will affect public health for generations to come. APHA has expressed deep concerns about this nominee and is asking its members to contact their senators and urge them to vote against Judge Kavanaugh’s nomination.