An ultra-conservative federal judge in Texas has lobbed another hand grenade in his long-running battle to limit access to reproductive healthcare around the country—this time by vacating a privacy rule intended to shield abortion seekers and providers from criminal and civil state investigations.

In a sweeping ruling late Wednesday, US District Judge Matthew Kacsmaryk of Amarillo held that the Biden administration’s attempt to protect reproductive health information from disclosure to law enforcement and other authorities was unlawful. In doing so, Kacsmaryk has opened the floodgates for states with bans on abortion and gender-affirming care to investigate patients who obtain treatment out of state, as well as their providers, using those patients’ own private health records.