A federal judge in Texas who declared the Affordable Care Act unconstitutional earlier in December stayed his ruling pending an appeal since residents in many states have already purchased their health insurance plans for 2019.

U.S. District Judge Reed O’Connor of the Northern District of Texas broadly upheld his initial Dec. 14 ruling, but said Americans would face great uncertainty during the appeal without a stay. O’Connor did say the states intervening to defend the ACA failed to show a likelihood they could succeed on appeal at the U.S. Court of Appeals for the Fifth Circuit.