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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- 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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Mental Illnesses May Soon Be the Most Common Pre-Existing Conditions
Because the prevalence of depression and anxiety disorders appears to have increased substantially since the start of the Coronavirus pandemic, if the ACA is repealed, mental illnesses could be the most common pre-existing conditions.
Blog Read MoreProtecting People With Pre-Existing Conditions Isn’t As Easy As It Seems
With the death of Justice Ruth Bader Ginsburg, a lawsuit before the Supreme Court to overturn the Affordable Care Act (ACA) suddenly has a much better chance of succeeding. And, that could make protections for people with pre-existing conditions an even bigger campaign issue.
Blog Read MoreFAQs: Health Insurance Marketplace and the ACA
This list of more than 300 Frequently Asked Questions (FAQs) covers the Affordable Care Act’s health insurance Marketplace (aka exchange), individual mandate, open enrollment, premiums and more. It provides answers to questions about specific groups, such as young adults, smokers, the uninsured, and non-traditional households.
FAQ Landing Page Read MoreA Court Ruling Striking Down the ACA Would Eliminate the Medicaid Expansion and Cause Millions of Low-Income People to Become Uninsured
Millions of low-income Americans currently covered by Medicaid likely would become uninsured if the Supreme Court were to strike down the Affordable Care Act in California v. Texas, a legal challenge the high court is scheduled to hear in early November, KFF experts explain in a new Policy Watch post.…
News Release Read MoreLoss of the Affordable Care Act Would Widen Racial Disparities in Health Coverage
In November, the Supreme Court is scheduled to hear arguments on a legal challenge that seeks to overturn the Affordable Care Act (ACA). This analysis shows that new coverage options under the ACA have contributed to large gains in coverage, particularly among people of color, helping to narrow longstanding racial disparities in health coverage.
Blog Read MoreAffordable Care Act
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…
Search Page Read MoreEliminating the ACA: What Could It Mean for Medicaid Expansion?
The debate over filling the Supreme Court seat previously held by Ruth Bader Ginsburg has brought renewed attention to the possibility of the Affordable Care Act (ACA) being overturned under the court challenge in California v. Texas, currently scheduled to be heard shortly after the election this November. The expansion of Medicaid was a central component of the ACA, and 39 states have now adopted the ACA expansion into their Medicaid programs. Because Medicaid is administered by states, under federal guidelines, there may be some confusion about how overturning the federal law would affect state Medicaid programs.
Blog Read MoreEffects of the ACA Medicaid Expansion on Racial Disparities in Health and Health Care
This issue brief examines how the ACA Medicaid expansion has affected racial disparities in health coverage, access to care, health outcomes, and economic outcomes.
Issue Brief Read MoreIs COVID-19 a Pre-Existing Condition? What Could Happen if the ACA is Overturned
If the ACA is overturned, federal law protection for people with pre-existing health conditions would end. This post examines what that could mean for people in the time of COVID-19, including whether and how insurers could deny coverage to people who have had COVID or other pre-existing conditions.
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