FORT WORTH, Texas (KXAN) — U.S. District Court Judge Reed O’Connor issued a memorandum opinion and order today, allowing a Fort Worth company to offer insurance to employees that does not cover pre-exposure prophylaxis (PrEP).

The ruling argues that the Affordable Care Act’s PrEP mandate violates protections granted by the Religious Freedom Restoration Act. Specifically, the order only gave that ruling to Braidwood Management Inc., a Christian for-profit business owned by GOP megadonor and talk show host Steven Hotze.

Hotze’s attorneys argue that he believes PrEP medications facilitate “homosexual behavior” outside of a Christian definition of marriage, and that allowing insurance coverage would “make him complicit in those behaviors.”

Reporting in 2018 by The Texas Tribune found that, according to records from the Texas Office of the Attorney General, half of all cases brought by Texas against the federal government appeared before O’Connor, an appointee of former President George W. Bush.

“Braidwood has shown that the PrEP mandate substantially burdens its religious exercise,” O’Connor’s order reads, “The burden thus shifts to Defendants to show that the PrEP mandate furthers a compelling governmental interest and is the least restrictive means of furthering that interest. Defendants have not carried that burden.”

Read the full order here:

O’Connor reserved ruling on the other plaintiffs in the case. The other plaintiffs include individuals who state similar religious beliefs as Braidwood, as well as Fort Worth Oral Surgery and Kelly Orthodontics. The owners of both companies attend the same church, Christ Chapel Bible Church in Fort Worth.

How will this impact Texans?

Christopher Hamilton, CEO of Texas Health Action, said that the ruling will hamper efforts to slow the spread of HIV in Texas.

“As a preventative medication, PrEP can be up to 99% effective at preventing HIV, which is absolutely phenomenal. It has changed people’s lives for the better because they’re able to have healthy sexual relationships with others,” Hamilton said. “There will be people affected by this, who will have this coverage removed from their plans.”

Texas Health Action operates the Kind Clinic in Austin and San Antonio, which offer a number of health services including no-cost access to PrEP.

“We have seen declines in the number of new HIV diagnoses in the Austin area. We can’t attribute everything to only one medication; however, this is an encouraging sign that as the number of people using PrEP has gone up steadily over the years, we see a decrease in HIV infections,” Hamilton said. “HIV does not discriminate. It can reach anyone who is sexually active.”