AMNA NAWAZ: A federal judge in Texas has ruled that employers cannot be required to cover key preventative health care benefits under the Affordable Care Act.

It jeopardizes free coverage of a wide range of services for some 160 million Americans.

The Biden administration is expected to request a stay on the ruling.

Larry Levitt is the executive vice president for health policy at the Kaiser Family Foundation, and joins us now.

Mr. Levitt, welcome.

And thanks for joining us.

Just to set the table here, this ruling stems from a case brought by Christian-owned and businesses and some others who argued they shouldn't have to cover HIV PrEP, which is a pre-exposure prophylaxis.

But what does this mean more broadly in terms of the implications?

LARRY LEVITT, Senior Vice President, Kaiser Family Foundation: Yes, I mean, on the one hand, this decision is not as broad as some of the other legal challenges we have seen to the Affordable Care Act.

I mean, this decision does not threaten the very existence of Obamacare, the subsidies that make coverage more affordable, preexisting condition protections.

On the other hand, this is a very significant decision; 100 million people in a typical year use the preventive services that the Affordable Care Act requires and requires insurers to provide with no deductibles and no co-pays.

The judge's decision does not throw out all of those preventive services.

But it's very significant and will affect millions of people over time.

AMNA NAWAZ: When you're talking about those preventative services and screenings, give us some examples.

What kinds of things are we talking about here?

LARRY LEVITT: Yes, so the kinds of preventive services that the ACA requires are very broad.

I mean, it's cancer screenings.

It's contraception.

It screenings for depression and anxiety.

Many of those will actually stay, because what this ruling does is says that any preventive services that were added after 2010, when the Affordable Care Act passed, are the ones that are thrown out.

So those will -- the ones that will no longer or could no longer be covered by insurers include PrEP, as you mentioned, medication that prevents HIV, statins that lower cholesterol, and help prevent heart disease, medications that help reduce the risk of breast cancer, lung cancer screening, so a narrower set of services than many people are getting, but still quite significant, and for many people's lives.

AMNA NAWAZ: So insurers can either just drop coverage for those kinds of services and screenings altogether or start charging enrollees for those.

What do you expect to happen?

LARRY LEVITT: I -- first of all, I don't think anything will happen immediately, because we're in the middle of middle of the calendar year.

And many insurance contracts are still in place.

But come next year, I think insurers will look at this ruling, if it stands, if the Biden administration does not successfully get a stay, insurers will look at it and make some decisions, I suspect they will still cover these services.

But many of them will be subject to deductibles or co-pays, which could be quite expensive for patients.

AMNA NAWAZ: We should point out the judge in this case basically ruled the government can't force employers to provide some of the services, because the task force that determined which should be covered wasn't -- was comprised of medical advisers, not government employees.

We mentioned that we expect the Biden administration to appeal.

So what happens next?

Walk us through the timeline.

LARRY LEVITT: Yes, so the first step will be an appeal to try to get a stay, because this judge in Texas not only said that the preventive services requirement doesn't apply to these employers, these religious employers in Texas, or even just in Texas, but applies nationwide.

So the Biden administration will certainly push for a stay.

And then this would go to the court of appeals in that region, which is a pretty conservative court, and, most likely, ultimately to the Supreme Court.

AMNA NAWAZ: We have got about a minute-and-a-half or so left.

I have to ask you more broadly, it was just a week ago the White House was celebrating 13 years of the Affordable Care Act and record high open enrollment numbers.

This was, as you mentioned, a narrow, but it was a key provision of the ACA.

What does all of this tell you about the future of the Affordable Care Act?

LARRY LEVITT: Yes, I mean, this is an enormously popular provision of the ACA.

I mean, this is not something that's controversial, like the individual mandate that required people to get insured or pay a penalty, or the employer mandate.

This was extremely popular.

And you're right.

I mean, the politics around the Affordable Care Act have really changed.

I mean, we're 13 years in.

The Biden administration has really reinvigorated the Affordable Care Act after the Trump administration tried to weaken it.

There's record enrollment.

There's record low uninsured rate now in the United States.

And Republicans really are not publicly talking about repealing the ACA anymore.

But this ruling potentially puts them on the hot seat.

AMNA NAWAZ: We will be watching all of this unfold in the weeks and months ahead.

Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, thank you for joining us.

LARRY LEVITT: Thanks for having me.