Earlier this week, two Democratic senators announced they have requested a criminal investigation into Supreme Court Justice Clarence Thomas — regarding, in part, a loan for a luxury RV provided by a longtime executive at UnitedHealth Group, one of America’s largest health insurers. Thomas apparently recused himself in at least two cases involving UnitedHealth when the loan was active, according to a Rolling Stone review. Yet, he separately chose to participate in another health insurance case and authored the court’s unanimous opinion in 2004.

The ruling broadly benefited the industry — shielding employer-sponsored health insurers from damages if they refuse to cover certain services and patients are harmed. Thomas’ advice to patients facing such denials? Pull out your checkbook. While UnitedHealth was not a party to the case, the company belonged to two trade associations that filed a brief urging the Supreme Court to side with the insurers.

“As we saw so starkly this term, Supreme Court decisions can have sweeping collateral implications: If the court rules in favor of one insurance giant, for instance, it tends to be a boon for all the other insurance giants, too,” says Alex Aronson, executive director at the judicial reform group Court Accountability. “That was the case here, and it’s a perfect example of why justices shouldn’t accept gifts — especially secret ones — from industry titans whose interests are implicated, whether directly or indirect.