A US federal judge in Texas Thursday ruled that private health insurance companies are not required to cover contraceptives, STD screenings or HIV prevention treatment (pre-exposure prophylaxis or PrEP).

The court held that the preventative care minimum of the 2010 Affordable Care Act (ACA) violated the claimant’s rights under the Religious Freedom Restoration Act. This ruling effectively blocks government enforcement of the mandate for insurance companies.

Under the ACA, three government agencies were given the ability to set mandatory coverage minimums for insurance companies. While many insurance companies cover more than what is set by the agencies, the minimum ensures that companies cover what the agencies consider to be basic care. In 2011, the agencies added all FDA approved contraceptives, STD screenings and PrEP treatment. The agencies considered these treatments to be preventative care, as the use of these treatments can allow for early detection or prevention of greater issues, such as cancer.

Six individuals and two businesses raised a claim against this minimum requirement, however, alleging that the inclusion of these preventive care screenings violated their religious beliefs. One plaintiff claimed that the inclusion of this minimum made them “complicit in facilitating homosexual behavior, drug use, and sexual activity outside of marriage between one man and one woman.” Others argued on a non-religious stance, claiming it was unfair to be forced to pay for coverage they would never use.

Even before this ruling, contraceptives, STD screening, and PrEP treatment were not easily accessible to everyone. Organizations such as the American Civil Liberties Union (ACLU) have been fighting for increased access to these treatments for many years.

In defense of birth control, the ACLU commented:

Access to contraception is critical to an individual’s autonomy, equality, and ability to participate in the social, economic, and political life of the nation. Yet for many people—particularly low-income women and teens—issues of cost and confidentiality make contraception inaccessible.

For many, the treatments included in this mandate are essential and often life-saving. Thursday’s ruling may make these treatments more inaccessible than ever before.