A U.S. circuit court of appeals issued a stay of a Texas district court decision that could jeopardize access to free preventive care for hundreds of millions of Americans. A Fifth Circuit Court of Appeals panel issued the stay while the court considers the federal government’s appeal of the lower court’s ruling that invalidated the Affordable Care Act (ACA) requirement that insurers cover, without cost-sharing, more than 100 preventive health services recommended by the U.S Preventive Services Task Force.

In March, Judge Reed O’Connor of the Northern District of Texas issued a decision finding that the requirement to cover any preventive care services recommended by the U.S. Preventive Services Task Force after March 2010 violates the U.S. Constitution’s Appointments Clause. The district court also found the mandate to cover PrEP medications for HIV prevention violates the rights of the plaintiffs who have religious objections. The Fifth Circuit is expected to hear arguments on the federal government’s appeal in the coming months.

The U.S. Department of Health and Human Services estimates that about 150 million individuals in private health plans and 80 million individuals with Medicare and Medicaid have benefited from the ACA policy that requires insurers to cover a wide range of preventive services without cost to patients.

Many insurers have pledged to continue providing preventive care at no cost to patients, but experts fear that there will be serious health consequences if the lower court ruling is allowed to stand. Research shows that even small costs deter many people from seeking preventive care, leading to sicker patients and more costly treatments.

The California Medical Association strongly supported the ACA’s preventive health benefits and the package of essential health benefits.