SESTA was incorporated into the House version of the bill with the "Allow States and Victims to Fight Online Sex Trafficking Act" (FOSTA) and the joint proposal was known as the "FOSTA-SESTA package".

[6][7] In an op-ed, Portman cited numbers from the National Center for Missing and Exploited Children, which showed an 846% increase in reports of suspected child sex trafficking to the organization from 2010 to 2015.

He attributed this largely to Backpage, an online classifieds service that had been accused of knowingly accepting ads which facilitated child sex trafficking, and filtered specific keywords in order to obfuscate it.

"[16] The New Jersey Coalition Against Human Trafficking called the FOSTA-SESTA package a "groundbreaking bill" in the effort to bring justice to victims.

While it is impossible to formulate laws to govern every possible situation, [the] legislation is a rational and measured effort to deal with a tragic and pernicious problem that is global in scope.

"[18] Writing on behalf of the U.S. Department of Justice, Assistant-Attorney General Stephen Boyd addressed Chairman of the House Judiciary Committee, Bob Goodlatte, expressing concerns that provisions of the bill would make it even harder to prosecute sex traffickers.

In an official statement Senator Ron Wyden stated, "I continue to be deeply troubled that this bill’s approach will make it harder to catch dangerous criminals, that it will favor big tech companies at the expense of startups and that it will stifle innovation.

[2] SESTA has been criticized on free speech grounds and by advocacy groups due to concerns about disproportionate impact and disruptions to the lives of sex workers.

[17] EFF staff attorney Aaron Mackey told the Washington Examiner that under SESTA, service providers would be required to proactively take action against sex trafficking activities, and would need a "team of lawyers" to evaluate all possible scenarios under state and federal law (which may be financially unfeasible for smaller companies).

[13] The EFF and the Internet Association argued that any online service could theoretically be used to "facilitate" sex trafficking, and that the law would have a chilling effect on voluntary moderation of websites (as encouraged by the "Good Samaritan provision" of section 230, which states that providers are not liable on account of "any action voluntarily taken in good faith to restrict access to or availability of material that the provider or user considers to be [objectionable]"),[34] as even the mere discovery of sex trafficking content could constitute knowing conduct of participation in a venture, and that dismissing the risk could constitute reckless disregard.

[17] The EFF further argued that websites which knowingly facilitate sex trafficking were already liable per Fair Housing Council of San Fernando Valley v. Roommates.com, LLC, which ruled that section 230 immunity does not apply if an online service was directly involved in the creation of content that violates civil law.

[35] In late March 2018 and early April 2018, following the bill's passage but prior to its implementation, courts in Massachusetts and Florida made rulings affirming that Backpage was liable for facilitating sex trafficking, because its practice of intentionally removing keywords pertaining to minors made it a provider of content subject to liability, as opposed to an interactive computer service.

[39][40] The Internet Association stated that it would "support targeted amendments to the Communications Decency Act that would allow victims of sex trafficking crimes to seek justice against perpetrators", but initially criticized SESTA for using terms which were undefined or broadly-interpreted in case law, and argued that it would "introduce new legal risk not just for internet services that do not knowingly and intentionally facilitate illegal conduct, but also create risk for an incredibly broad number of innocent businesses by expanding the notion of contributory liability.

[13] It has been suggested that SESTA could be used as a model for future exclusions from Section 230 immunity, such as copyright infringement (especially with its support from major film studios), and terrorism content.

[16] Like SESTA, the FOSTA-SESTA package would clarify that section 230 of the CDA does not prevent states and victims of sex trafficking from pursuing a course of action against interactive computer service providers, such as Backpage.

"[16] Craigslist ceased offering its "Personals" section within all US domains in response to the bill's passing, stating "Any tool or service can be misused.

"[50] Furry personals website Pounced.org voluntarily shut down, citing increased liability under the bill, and the difficulty of monitoring all the listings on the site for a small organization.

His ruling was a response to a constitutional challenge brought by the defendant in the case of United States v. Martono, a criminal matter relating to the seizure of CityxGuide.

The current landscape of the online commercial sex market heightens already-existing challenges law enforcement face in gathering tips and evidence.

In June 2020, DOJ brought one case under the criminal provision established by section 3 of FOSTA for aggravated violations involving the promotion of prostitution of five or more people or acting in reckless disregard of sex trafficking.