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 MoreWant to protect people with preexisting conditions? You need the full Affordable Care Act.
In this perspective published by the Washington Post, KFF Executive Vice President for Health Policy Larry Levitt explains why the popular Affordable Care Act provisions that ensure people with pre-existing conditions can access affordable health insurance can’t easily be preserved if other related provisions are overturned.
Perspective Read MoreHealth Policy Resources for Covering the 2020 Elections
As the 2020 Election Day approaches, many candidates continue to focus on health care issues, including on the public health and economic response to COVID-19, the future of the Affordable Care Act, health care costs and abortion. To help reporters understand and cover these issues, KFF offers independent, non-partisan policy…
News Release Read MoreDemographics, Insurance Coverage, and Access to Care Among Transgender Adults
This analysis seeks to better understand the experiences of transgender people in the US health care system. We examine the demographic characteristics of transgender adults ages 18 and over and their access to health care and insurance coverage.
Issue Brief Read MoreJoe Biden’s Big Lead on Health Care Issues
In an Axios column, Drew Altman discusses how this election year health isn’t a single issue — but several — and Joe Biden has the edge over President Trump on all of them, even as opposition to the ACA remains popular with Trump’s base.
Perspective Read More2021 Premium Changes on ACA Exchanges and the Impact of COVID-19 on Rates
This brief summarizes premium rate filings in all 50 states and the District of Columbia and finds the majority of rate changes for 2021 are moderate, with increases or decrease of a few percentage points. Insurers say the COVID-19 pandemic is putting both upward and downward pressure on health costs in 2021.
Issue Brief Read MoreMedicaid Covers People with Pre-Existing Conditions, Too
In recent weeks, the possible overturning of the Affordable Care Act (ACA) in court and the upcoming election have focused attention on the issue of protections for people with pre-existing conditions. While the focus has been on the ACA’s private insurance protections, Medicaid also plays a significant role in covering people with pre-existing conditions.
Blog Read MorePublic Opinion on Single-Payer, National Health Plans, and Expanding Access to Medicare Coverage
Slideshow Read MoreKFF Health Tracking Poll – October 2020: The Future of the ACA and Biden’s Advantage On Health Care
The poll examines the public’s views on the Supreme Court case to overturn the Affordable Care Act and its protections for people with pre-existing conditions. Less than a month from the results of the 2020 presidential election, this poll examines the top issues for voters (the economy, the coronavirus pandemic, health care, criminal justice and policing, among others) as well as which candidate, Biden or Trump, they think has the better approach to handle key health care policy areas.
Report Read MoreTracking Poll: A Large and Growing Majority, Including Republicans, Does Not Want the Supreme Court to Overturn the ACA’s Protections for People with Pre-Existing Conditions
As the Senate considers Judge Amy Coney Barrett’s nomination to the Supreme Court, the October KFF Health Tracking Poll finds a large majority (79%) of the public do not want the Court to overturn the Affordable Care Act’s protections for people with pre-existing medical conditions, up 17 percentage points since…
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