A federal judge in Texas on Thursday struck down a key provision in the Affordable Care Act that mandates insurers provide preventive services for free, including those for cancer screenings.

The ruling from U.S. District Judge Reed O'Connor in Fort Worth zeroes in on the makeup of the U.S. Preventive Services Task Force, the panel charged with enforcing provisions of the ACA.

O'Connor found that preventive care recommendations issued by the panel do not have to be followed because he found their volunteer members, who are 16 medical professionals and scientists charged with issuing the recommendations, do not have to be appointed by the president nor confirmed to their posts by the Senate.

As it stands, the ACA, sometimes known as "Obamacare," mandates that insurers have to cover more than 100 preventive health services, as directed by the task force.

Thursday's ruling now means that insurance companies are no longer required to cover the preventive services spelled out in the decision. This includes screenings for various forms of cancer like breast cancer and lung cancer, screenings for diabetes, interventions for those who are pregnant and other preventive forms of care.

This could affect more than 150 million Americans who hold private insurance with preventive services covered via the ACA, according to January 2022 data by the Department of Health and Human Services.

O'Connor did leave the contraceptive provision in the ACA untouched by Thursday's decision.

The case was brought against the federal government by a Christian dentist, John Kelley, and Braidwood Management, a group operated by conservative Texas activist, Steven Hotze. The lead attorney for the plaintiffs is Jonathan Mitchell, one of the architects of Texas' 2021 abortion restrictions.

Mitchell did not immediately return The Texas Tribune's call for comment.

The order follows a previous ruling made by O'Connor in September that HIV prevention drugs do not have to be covered by the ACA, siding with a group of Christian conservatives that argued it violated their religious freedom. And in 2018, O'Connor ruled that the ACA was unconstitutional. His ruling was later struck down by the U.S. Supreme Court.

The Biden administration will likely appeal Thursday's decision. Insurance coverage contracts typically last through the end of the year, meaning there will not likely be changes to insurance policies and what they can cover ahead of 2024.

We can't wait to welcome you Sept. 21-23 to the 2023 Texas Tribune Festival, our multiday celebration of big, bold ideas about politics, public policy and the day's news — all taking place just steps away from the Texas Capitol. When tickets go on sale in May, Tribune members will save big. Donate to join or renew today.

This article originally appeared in The Texas Tribune at https://www.texastribune.org/2023/03/30/texas-aca-preventive-care/.

The Texas Tribune is a member-supported, nonpartisan newsroom informing and engaging Texans on state politics and policy. Learn more at texastribune.org.