Chief Justice John Roberts Jr.’s lone concurrence in the Louisiana abortion case from last term teed up a divided decision in a federal appellate court Tuesday, as judges parsed the meaning and scope a U.S. Supreme Court decision that has proved vexing to courts around the country.

The full U.S. Court of Appeals for the Sixth Circuit on Tuesday, ruling 9-7, reversed a panel decision that had upheld an injunction blocking an Ohio anti-abortion law. Under the state law that now can be enforced, a medical provider commits a felony for performing an abortion—at any point in the pregnancy—with knowledge that the fetus has Down syndrome.