Former President Barack Obama’s legacy suffered a setback this week after the U.S. Supreme Court delivered a major 7-1 ruling.

As noted by The Hill, the Supreme Court rolled back an Obama-era rule that changed how hospitals are reimbursed for care given to low-income patients.

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While this hasn’t gotten national media attention, the ruling is a major blow for Obamacare, which is Obama’s self-described greatest accomplishment.

The change was reversed, thanks to a lack of “proper notice and comment regulations in implementing the formula.”

The court’s decision was a 7-1 in favor of vacating the rule, with Justice Brett Kavanaugh not involved in the case.

Justice Neil Gorsuch wrote the majority opinion, and liberal Justice Stephen Breyer was the only dissenting member of the court on the Medicare case.

The court decided that hospitals who sued over the 2014 decision to lower their payments when serving low-income patients had a valid case, because of the lack of notice in the payment changes.

Here’s part of what Gorsuch wrote in the opinion for the majority:

“In 2014, the government revealed a new policy on its website that dramatically—and retroactively—reduced payments to hospitals serving low-income patients. Because affected members of the public received no advance warning and no chance to comment first, and because the government has not identified a lawful excuse for neglecting its statutory notice-and-comment obligations, we agree with the court of appeals that the new policy cannot stand.”

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Nicholas Bagley, a law professor at the University of Michigan, took to Twitter on Monday to voice his concern over how big of a deal the ruling is to Medicare.

Bagley warned that the court’s ruling imposes burdens on the federal Medicare agency, known as the Centers for Medicare and Medicaid Services, that could hinder the implementation of the program.

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