WICHITA FALLS, Texas — A federal appeals court on Monday upheld a Texas federal court ruling that exempts a group of religious health care providers from the abortion and gender transition requirements of the Affordable Care Act.

In an 18-page opinion filed Friday, the three-judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans upheld the permanent injunction by U.S. District Judge Reed O’Connor in Wichita Falls.

The Franciscan Alliance, a Catholic hospital network in Indiana and Illinois, and the Christian Medical & Dental Associations and their 19,000 members nationwide sued to block the Biden administration from enforcing ACA provisions they feared would require them to perform abortions or gender-transition treatment.

In his ruling last August, O’Connor interpreted regulations of the U.S. Department of Health and Human Services as forcing the plaintiffs to choose between their beliefs and their livelihood, resulting in “irreparable injury.”

The 5th Circuit ruling came in an HHS appeal of the O’Connor injunction and applied only to the plaintiffs in the case. However, the plaintiffs hailed the decision as protection for health care professionals nationwide.

“This victory in Texas against government coercion means healthcare professionals can continue to exercise medical judgment and ethical care based upon sound medical evidence and Hippocratic standards of patient care instead of any ideology,” said Dr. Mike Chupp, chief executive of the Christian Medical and Dental Associations.

A message to the Justice Department, which represented HHS in its appeal, did not immediately return a message seeking comment.