The US Supreme Court has rejected a Trump-backed challenge by Republican-led states to former President Barack Obama's healthcare overhaul.
Despite the court's conservative tilt, its nine justices ruled by 7-2 that the challengers did not have legal standing to sue.
It is the third time since 2010 that the Affordable Care Act (ACA), known as Obamacare, has survived a challenge.
The law gave millions of low-income Americans access to medical insurance.
It bans insurers from denying coverage due to pre-existing conditions.
Thursday's ruling did not address the question of whether a key provision in the law was unconstitutional.
The legal challenge from Texas and 17 other Republican-governed states had been backed by former President Donald Trump, who promised to have the act repealed when he was elected in 2016.
Republicans tried and failed to overturn the law in Congress when they controlled both houses and in the courts on numerous occasions.
Earlier this month, the White House said a record 31 million Americans were now covered by healthcare under the ACA.