As many as 10 million Americans could face higher out-of-pocket costs if a district court decision regarding preventive health coverage provisions of the Affordable Care Act is upheld on appeal, a KFF report found.

The ACA requires most private plans to cover in-network preventive services at no cost to enrollees. In March, however, the U.S. District Court in the Northern District of Texas ruled in the case of Braidwood Management v. Becerra that this mandate is partially unconstitutional. The decision excluded all preventive care recommendations issued by the United States Preventive Services Task Force on or before March 23, 2010, when the ACA was signed into law.

"As a result, the ruling could affect more services and people over time as new drugs and treatments are developed, recommended and adopted," according to the report. "For example, this analysis — which relies on 2019 claims data to reflect utilization in a typical pre-pandemic year — does not consider the ruling's impact on more recent preventive service recommendations, like PrEP for HIV."