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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Preexisting Conditions and Republican Plans to Replace Obamacare
In this Wall Street Journal Think Tank column, Drew Altman discusses new data highlighting why pre-exisitng conditions could be a flashpoint issue in the Affordable Care Act repeal and replace debate.
Perspective Read MoreSurprise Medical Bills
This brief explores the problem of “surprise medical bills” — charges arising when an insured individual inadvertently receives care from an out-of-network provider. It reviews studies on the extent of the issue, including Kaiser Family Foundation polling data, and outlines state and federal policy responses, including rules and proposed rules for Medicare and plans in Affordable Care Act marketplaces.
Issue Brief Read MoreHow has the ACA Medicaid Expansion Affected Providers Serving the Homeless Population: Analysis of Coverage, Revenues, and Costs
To further understand how the first full year of Medicaid expansion has affected patients who are homeless and the providers who care for them, this analysis uses data from the Uniform Data System (UDS) for health centers to examine changes in insurance coverage, revenues and costs among Health Care for the Homeless (HCH) projects serving the homeless population.
Issue Brief Read MorePatient Cost-Sharing in Marketplace Plans, 2016
This brief and accompanying slides examine cost sharing – deductibles, copayments and coinsurance – in 2016 insurance plans sold on the Affordable Care Act’s (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).
Issue Brief Read MoreWomen’s Health Issues Journal: Women, Private Health Insurance, and the Affordable Care Act
In this issue of the Women’s Health Issues journal, Alina Salganicoff and Laurie Sobel discuss how the private insurance reforms and expansions in the Affordable Care Act (ACA) have affected access to coverage for women and where gaps remain.
Issue Brief Read MoreMedicare Advantage Hospital Networks: How Much Do They Vary?
This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and other plan features, including premiums, quality star ratings, per capita Medicare spending, parent organization, and plan tax status.
Report Read MoreTwo Substantive Sides to Debate Over Obamacare’s ‘Cadillac Tax’
In this column for The Wall Street Journal’s Think Tank, Drew Altman says debate about whether to keep or repeal the Cadillac tax is more than a debate between sound policy and good politics, there are strong substantive arguments on both sides.
Perspective Read MoreMarketplace Health Plan Options for People with HIV Under the ACA: An Approach to More Comprehensive Cost Assessment
Based on an analysis of 300 possible scenarios, this brief estimates costs HIV positive individuals might expect to face when enrolled in marketplace health plans and describes the characteristics of plans that might offer the greatest value.
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Analysis of UnitedHealth Group’s Premiums and Participation in ACA Marketplaces
This analysis looks at how a potential withdrawal by UnitedHealth Group from the Affordable Care Act (ACA) marketplaces in 2017 could impact insurer competition and premiums, finding a significant impact in some markets, though it would have a minimal effect on the average benchmark premium nationwide, The impacts of a UnitedHealth withdrawal would vary considerably by state and market area, with a more pronounced effect in rural areas. Since UnitedHealth often is not one of the lower cost plans, the effect nationally on premiums of an exit by the insurer would be modest.
Issue Brief Read MoreJAMA Forum: Reports of Obamacare’s Demise Are Greatly Exaggerated
In this post for The JAMA Forum, the Kaiser Family Foundation’s Larry Levitt discusses UnitedHealth’s exit from Affordable Care Act marketplaces, the possibility of bigger premium increases in 2017, and why these challenges are unlikely to significantly affect long-term sustainability of the market and the law.
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