More than a decade after its enactment, the future of the Affordable Care Act (ACA) remains uncertain as the U.S. Supreme Court takes up another challenge to the law’s constitutionality in California v. Texas (known as Texas v. U.S. in the lower courts). Oral argument is scheduled for Tuesday, November 10, 2020.
The ACA remains in effect while the litigation is pending. However, if all or most of the law ultimately is struck down, it will have complex and far-reaching consequences for the nation’s health care system, affecting nearly everyone in some way.
For information about ACA Marketplace Open Enrollment, including fact sheets and 300+ FAQs, visit our collection of resources on Understanding Health Insurance.
Featured Affordable Care Act Resources

Explaining California v. Texas: A Guide to the Case Challenging the ACA
This issue brief answers key questions about California v. Texas (known as Texas v. US in the lower courts), the case challenging the Affordable Care Act to be heard by the Supreme Court.
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Related Affordable Care Act Resources
- 5 Charts About Public Opinion on the Affordable Care Act and the Supreme Court
- Affordability in the ACA Marketplace Under a Proposal Like Joe Biden’s Health Plan
- Eligibility for ACA Health Coverage Following Job Loss
- Protecting People With Pre-Existing Conditions Isn’t As Easy As It Seems
- Is COVID-19 a Pre-Existing Condition? What Could Happen if the ACA is Overturned
- Mental Illnesses May Soon Be the Most Common Pre-Existing Conditions
- Pre-Existing Condition Prevalence for Individuals and Families
- Eliminating the ACA: What Could It Mean for Medicaid Expansion?
- Loss of the Affordable Care Act Would Widen Racial Disparities in Health Coverage
- Loss of the ACA Could Greatly Erode Health Coverage and Benefits for Women
- The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
- FAQs: Health Insurance Marketplace and the ACA
- Status of State Medicaid Expansion Decisions: Interactive Map
- Preventive Services Tracker
- Tracking Section 1332 State Innovation Waivers

Potential Impact of California v. Texas Decision on Key Provisions of the Affordable Care Act
The Supreme Court will review the constitutionality of the Affordable Care Act (ACA) this November in California v. Texas. This fact sheet summarizes the major provisions of the ACA, illustrating the breadth of its changes to the health care system. If all of most of the ACA is struck down, many of these provisions could be eliminated.
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A Year of Crisis: How COVID-19 Upended the Election’s Focus on Health Care Policy—Or Did It?
In this post, Ashley Kirzinger and Mollyann Brodie examine how the COVID-19 pandemic and other crises shook up the mix of issues voters care about without changing the 2020 presidential race’s core dynamic as a referendum on President Trump’s first term in office.
Perspective Read MoreLoss of the ACA Could Greatly Erode Health Coverage and Benefits for Women
This brief examines what the loss of the Affordable Care Act (ACA) would mean for women’s coverage and access to health care.
Issue Brief Read MorePreventive Services Tracker
The Affordable Care Act (ACA) requires new private health insurance plans to cover many recommended preventive services without any patient cost-sharing. This tracker presents up-to-date information on the adult preventive services nongrandfathered private plans must cover, by condition, including a summary of the recommendation, the target population, the effective date of coverage, and related federal coverage clarifications.
Report Read MorePotential Health Policy Administrative Actions Under President Biden
This brief outlines the potential health policy actions that President Biden could take using executive authority, based on campaign pledges, and actions that would reverse or modify regulations or guidance issued by the Trump Administration.
Issue Brief Read More5 Targeted Actions a Biden Administration Could Use to Expand Medicaid Coverage
The recent election of former Vice President Joe Biden as well as the on-going effects of the coronavirus pandemic and related economic downturn are the key issues that will substantially shape Medicaid policy over the next year.
Issue Brief Read MoreThe Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid
In states that do not implement the Medicaid expansion under the Affordable Care Act (ACA), many adults will fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. Nationwide, 2.2 million poor uninsured adults are in this situation. This brief presents estimates of the number of people in non-expansion states who could have been reached by Medicaid but instead fall into the coverage gap and discusses the implications of them being left out of ACA coverage expansions.
Issue Brief Read MoreJoe Biden’s New Health Care Agenda (and CMS’s Big Role In It)
With the Georgia runoff elections giving Democrats control of the U.S. Senate, Drew Altman discusses President-elect Biden’s potential health care agenda and suggests that the Centers for Medicare & Medicaid Services could have an expanded role and that it may be time to rename it and elevate it to a cabinet agency.
Perspective Read MoreMedicaid Expansion Enrollment and Spending Leading up to the COVID-19 Pandemic
This issue brief analyzes enrollment and spending trends related to the Affordable Care Act’s Medicaid expansion ahead of the coronavirus pandemic and examines potential consequences of recent enrollment increases.
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