In a blow to the managed care industry, the Supreme Court chose to delay intervening in Texas v. United States, the Republican state attorneys general-led lawsuit that would overturn the Affordable Care Act (ACA), AIS Health reported.

“By declining to take up this case in an expedited manner, the Supreme Court leaves in place the cloud of uncertainty that hangs over the Affordable Care Act,” said Association for Community Affiliated Plans (ACAP) CEO Margaret A. Murray in a press release. “We are disappointed in the Court’s decision. Consumers will continue to pay the price for this confusion as the case stagnates, but we remain confident the ACA will withstand this challenge.”

ACAP cited general regulatory uncertainty as a significant source of risk for the managed care industry, and argued that the ambiguous outlook for the ACA contributes to rising costs for care and resulting higher premiums. “That uncertainty has already spread across the health care system. Plans will postpone investment and innovation in the individual market, dampening competition,” Murray said.

Though the high court’s delay in reviewing the case against the ACA was unpopular in the health insurance industry, it wasn’t entirely unexpected. According to press reports, the court rarely intervenes in lower court decisions unless there is an urgent matter at hand. Payer groups’ arguments that uncertainty could severely disrupt health care markets apparently did not meet that standard of crisis.

With the court’s decision, the suit could now stay out of the 2020 election’s limelight. If the Supreme Court declines to hear the case at all (which the justices haven’t yet decided), it will return to U.S. District Judge Reed O’Connor’s Fort Worth courtroom and, if necessary, make its way through the regular appeals process, which could take months or years. O’Connor, who was appointed to the bench by George W. Bush in 2007, first heard the case in 2018 and ruled that the entire ACA was unconstitutional.