A Texas federal judge on Thursday ruled against a key part of the Affordable Care Act.

Judge Reed O’Connor wrote that insurers and employers should not have to cover a vast amount of preventative care cost-free. The ruling applies nationwide.

If the decision stands on appeal, standard doctor’s visits for contraception, cancer screenings, HIV medication and a lot of pregnancy-related care may no longer be free to patients.

O’Connor ruled that the federal agency that decides which medical care all insurers must cover, the U.S. Preventive Services Task Force, is unconstitutional, and thus that it cannot enforce access to free preventive care.

Here is a list of screenings and care affected by the ruling.

The lawsuit was brought by Christian-owned businesses and several individuals who said that the Affordable Care Act’s requirement that they cover some preventive care, including PrEP medication for HIV patients and birth control, violated their religious rights.