A US judge ruled Wednesday in favor of Christian employers who refuse, on religious grounds, to provide workers with health insurance that covers the cost of drugs that help prevent HIV/AIDS.

District Judge Reed O'Connor of a Texas federal court, known for making several rulings hostile to former president Barack Obama's sweeping health care law, took aim at a new aspect of the legislation nicknamed Obamacare.

The law requires private insurers to reimburse certain preventive care as defined by health authorities. In 2020, they included PrEP -- pills that act to prevent HIV transmission.

Two companies and several individuals went to court to challenge the coverage of the drugs, saying it violates their religious beliefs by making them "complicit in facilitating homosexual behavior," O'Connor said in his decision.

One of the plaintiffs was facing fines of $100 per employee per day for failing to comply with the Obamacare law, said the judge, who ruled that the requirement to reimburse the cost of PrEP pills violates the federal Religious Freedom Restoration Act.

President Joe Biden's Democratic administration will likely appeal the ruling.

"The administration is reviewing today's decision by the Northern District of Texas," White House Press Secretary Karine Jean-Pierre said on Twitter, noting that the Affordable Care Act "has been the law of the land for over 10 years."

The Texas decision was strongly criticized by the Speaker of the House of Representatives, Nancy Pelosi.

"This disturbing decision amounts to open homophobia," Pelosi, a Biden ally, said in a statement.

PrEP, short for pre-exposure prophylaxis, was approved by the US Food and Drug Administration in 2012 and is now routinely recommended for high-risk people who are HIV-negative to prevent them from becoming infected.

When taken daily, PrEP reduces the risk of infection by 99 percent, but only 23 percent of people who could benefit from it were using the medicine in 2019.

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