On Thursday, Federal Judge Reed O’Connor of the Federal District Court for the Northern District of Texas ruled that free preventative Obamacare is unconstitutional. This nationwide injunction took effect immediately.

The expansive ruling will impact healthcare for millions of patients, who now face the termination of their free preventive care like health screenings for issues such as diabetes, HIV, cancer, depression, and heart disease, along with pap smears, programs to stop smoking tobacco, and more.

The new ruling in its broad scope limits prevents the Biden administration from applying a law that previously offered patients this free preventive care. However, it is expected the Biden administration will quickly appeal this ruling.

The controversial new ruling, if it is not successfully appealed, will mean that millions of Americans now with Obamacare will face new insurance rules. For the first time since 2010, insurance firms will be able to decide how they would cover specific preventive services.

White House press secretary Karine Jean-Pierre said the Justice Department and the Department of Health and Human Services are reviewing the injunction.

In a statement, Ms. Jean-Pierre said, “This case is yet another attack on the Affordable Care Act. Preventive care saves lives, it saves families money and protects and improves our health.”

The Centers for Disease Control and Prevention (CDC) reports that preventive care services may be saving over 100,000 lives in the U.S. annually. The CDC reports that conditions such as heart disease, diabetes and cancer, the same conditions now banned by the new judge’s ruling from getting free screenings, are responsible for 7 out of 10 American deaths every year.

According to a study reported by the National Library of Medicine at the National Institutes of Health, “Greater use of preventive services in U.S. health care could save lives at little or no cost.” The study states that “increasing the use of these services from current levels to 90 percent in 2006 would result in total savings of $3.7 billion, or 0.2 percent of U.S. personal health care spending.”

The Texas case is BRAIDWOOD MANAGEMENT INC., et al., Plaintiffs, v. XAVIER BECERRA, et al. The owner of the management firm, Dr. Steven F. Hotze, is a Republican donor and Houston doctor. Mr. Hotze has challenged Obamacare, previously known as the Affordable Care Act, in court previously.

The plaintiffs, including Mr. Hotze, argued before the court that the current panel, all expert volunteers, who create binding recommendations on what should be included in free preventive care, are unconstitutional because its members are not elected to office and confirmed by the Senate or appointed by the President.

The plaintiffs also argued that preventive drugs used successfully for HIV and AIDS should not be covered by free Obamacare, because it violates the 1993 Religious Freedom Restoration Act, which prevents the US government from imposing a “burden” on any American’s religious freedom. In particular, the plaintiffs claim the free preventive Obamacare for HIV and AIDS care, via the successful treatment using pre-exposure prophylaxis, or PrEP, violated, violated their company, Braidwood Management’s, religious freedom.

Jesse Milan Jr., J.D., president and CEO of AIDS United, said the judge’s decision is dangerous and racist.

“Today’s decision represents a fundamental misunderstanding of the Constitution, the Affordable Care Act, religious liberty and the HIV epidemic,” said Milan, Jr. “HIV prevention, cancer screenings, STD tests and other preventative services are all an indispensable part of health care. They cannot be tossed aside. And who will be hit hardest by this decision? The Black and Brown people who make up nearly three-quarters of new HIV diagnoses. As a lawyer, I’m shocked by this decision. And as a Black gay man living with HIV, I’m offended and angered that a federal court issued a ruling that will intentionally stop progress toward racial and LGBTQ health equity and ending the HIV epidemic. It is truly shameful.”

About 151 million Americans have now lost their free coverage.