Healthcare stocks were jolted after news of a Texas judge’s ruling that the Affordable Care Act was unconstitutional, with hospital and insurance stocks among the worst performers of a selloff on Dec. 17, Bloomberg reported.

A Texas judge has ruled the Affordable Care Act unconstitutional in its entirety, throwing the American healthcare system into an uncertain future.

New York and California approved the $67 billion acquisition of Express Scripts by Cigna on Dec. 13, but New Jersey has yet to give its approval, according to a public filing.

Walmart and Express Scripts extended an existing network agreement to provide member clients with Express Scripts access to Walmart’s prescription services.

The Texas 21 coalition—a partnership among several healthcare organizations across Texas—is advocating to increase the smoking age from 18 to 21 across the state, according to a new report published in the Longview News-Journal. Raising the age, the coalition believes, will reduce the financial burdens of treating lung cancer and other diseases.

The United States pays far more for prescription drugs than other countries, but health outcomes aren’t much better—and sometimes, they’re worse—according to Axios.

Though regulators have signed off on the $69 billion merger between CVS Health and Aetna, a U.S. District Court judge is poised to block the deal, The New York Post reported.

Healthcare organizations are already looking ahead into 2019, and there are six trends to be aware of for the coming year, according to PwC’s report, “Top health industry issues of 2019: The New Health Economy Comes of Age.”