Rebecca Shabad is a politics reporter for NBC News based in Washington.
Associated Press contributed .
WASHINGTON — A federal judge in Texas has struck down Affordable Care Act provisions that require health insurers to provide some free preventive care services.
The ruling could jeopardize coverage nationwide for people relying on the health care law for preventive services such as screenings for cancer as well as HIV drugs.
In the decision, U.S. District Judge Reed O'Connor mentioned his previous ruling on the structure of the U.S. Preventive Services Task Force, which was created under Obamacare and helps determine preventive services coverage, saying it violates the appointments clause of the Constitution and thus its related preventive care mandates are unlawful.
O'Connor also said Obamacare's requirement to cover drugs preventing HIV, known as PrEP, violates the religious rights of plaintiffs under the Religious Freedom Restoration Act of 1993.
The plaintiffs who brought the lawsuit objected to purchasing health insurance that provided coverage for those drugs, the human papillomavirus vaccine, contraceptives, and screenings for sexually transmitted diseases because "coverage for those services violates their religious beliefs by making them complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman," O'Connor wrote.
In September, the judge said the preventive services requirements were unconstitutional, but he hadn’t decided whether the determination should apply nationally, a decision he made in Thursday's ruling.
The Department of Health and Human Services did not immediately respond to NBC News' request for comment.
The Biden administration and more than 20 states had asked the judge not rule broadly against the preventive care requirement, which they said millions now relied on to safeguard their health.
O'Connor, who was appointed by President George W. Bush, has issued a number of rulings targeting Obamacare in recent years. In 2018, he struck down the 2010 health care law, saying, "The individual mandate can no longer be fairly read as an exercise of Congress’s tax power and is still impermissible under the interstate Commerce Clause — meaning the individual mandate is unconstitutional."
The Supreme Court, however, ultimately ruled in favor of the law, rejecting GOP efforts to dismantle it.
