Texas Federal District Judge Reed O’Connor, of the Northern District of Texas, has struck down a key provision of the Affordable Care Act, also known as Obamacare. O’Connor has recently settled a case about private insurers and employers being mandated to offer coverage for contraceptives and preventative HIV drugs, stating that it violated their religious rights.

The Affordable Care Act requires all insurers to cover certain preventative care services to people without them paying out of pocket. The case started when a Christian dentist and Texas conservative activist opposed mandatory coverage for contraceptives and preventative HIV drugs because it would encourage sexual immorality and homosexual behavior. Requiring private insurers and employers to cover the cost violates their religious rights.

Judge O’Connor went further to strike down the task force that, under the Affordable Care Act, makes the recommendations for what treatments private insurers and employers must cover the cost of. The Preventative Services Task Force is made up of medical experts. However, they are also volunteers, and they are not appointed in that role by the President and affirmed by the Senate. Thus O’Conner states that the task force violates the Appointments Clause. The Appointments Clause states that policy decisions have to be made by government employees, not private volunteers. 

Judge O’Connor ruled that the Preventative Services Taskforce is not a constitutionally binding authority to order what insurers have to cover. They are not appointed by the President and confirmed by the Senate, and thus their mandates are not legally binding. 

The United States Preventative Services Taskforce has been making recommendations since 2010, and if this decision is upheld, all the way to the Supreme Court even, it would undermine all they have mandated to be covered by insurers. Their recommendations for insurance to cover the cost are not limited to contraceptives and preventative HIV drugs. They are also various cancer screenings, heart screenings, and other treatments that are preventative for different diseases. 

Judge Reed O’Connor is infamous for trying to strike down Obamacare completely in 2018. However, his decision was overturned by the Supreme Court, which still ruled Obamacare lawful. 

O’Connor’s decision may not go into effect until it is permanently decided by higher courts. The Biden Administration plans on appealing the decision to the 5th Circuit Appeals Court. This could be a case that goes all the way to the Supreme Court.