U.S. Federal Judge Reed O’Connor issued a ruling Thursday to stop the Biden administration from enforcing some Affordable Care Act mandates nationwide.

CNN reported those include offering some preventive care services like mammograms and screenings for sexually transmitted diseases at no cost to the patient.

This affects nearly 168 million people on employer health insurance or obtaining insurance through the individual market created by the act, Politico said.

The Associated Press said that “this time O’Connor blocked only the requirement that most insurers cover a range of preventive care,” the decision coming more than four years after the judge’s ruling that “Obamacare” was unconstitutional. That decision was overturned.

According to multiple news sources reporting on the ruling, the free preventive care covered by the Affordable Care Act that the ruling jeopardizes includes:

  • Screenings for cancer, mental health, HIV and diabetes.
  • Colonoscopies.
  • Pap smears.
  • Tobacco cessation services.
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The New York Times said the ruling was issued in the form of a nationwide injunction. Lawrence O. Gostin, health policy expert at Georgetown University, told the news outlet that the ruling takes effect immediately. “It might be that tomorrow, a woman might wake up and find that her mammogram is not covered.”

O’Connor struck down recommendations by the U.S. Preventive Services Task Force, which is tasked with deciding if some preventive care treatments will be covered by the Affordable Care Act, per CNN.

The article said O’Connor claimed the task force’s recommendations “violated the Constitution’s Appointments Clause.” He has previously deemed the Affordable Care Act’s requirement for insurers and employers to offer free plans covering HIV prevention measures — including a drug that is designed to prevent disease spread — unlawful.

U.S. Preventive Services Task Force

According to Politico, employers argued whether “recommendations made by the U.S. Preventive Services Task Force can be enforced, because its members are private medical experts, not government employees.”

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“‘The Appointments Clause says major policy decisions have to be made by an ‘officer of the United States,’ and can’t be made by just somebody off the street,’ explained Nicholas Bagley, a professor at the University of Michigan whose research focuses on the implementation of the Affordable Care Act,” Politico reported.

CNN said, “It is likely the case will be appealed, and the Justice Department has the option to ask that O’Connor’s ruling be put on pause while the appeal is litigated.”

“The White House press secretary, Karine Jean-Pierre, said the Justice Department and the Department of Health and Human Services were reviewing the decision,” The New York Times reported.