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

Sep 1, 2020

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

Sep 22, 2020

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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September 26, 2016 Fact Sheet

10 FAQs: Medicare’s Role in End-of-Life Care

About eight of 10 of the 2.6 million people who died in the US in 2014 were people on Medicare, making Medicare the largest insurer of health care provided during the last year of life. These Frequently Asked Questions explain Medicare’s role in or coverage of end-of-life care, advance care planning, advance directives, and hospice care. They also provide information on Medicare spending on end-of-life care, changes to the physician fee schedule, and how related issues arose prior to the passage of the Affordable Care Act.

September 20, 2016 Issue Brief

Findings from the Field: Medicaid Delivery Systems and Access to Care in Four States in Year Three of the ACA

Based on case studies and focus groups, this brief reviews delivery systems and access to care for Medicaid enrollees in Colorado, Connecticut, Kentucky, and Washington as of Spring 2016. The findings provide an on-the-ground view of Medicaid delivery systems and enrollees’ experiences accessing care three years after implementation of the Medicaid expansion. This brief builds on previous reports that examined states’ preparation for implementation prior to the initial ACA open enrollment period and their experiences after completion of the first and second open enrollment periods.

September 20, 2016 Issue Brief

Findings from the Field: Enrollment and Consumer Assistance in Four States in Year Three of the ACA

Based on case studies and focus groups, this brief reviews experiences with Medicaid and Marketplace enrollment, renewal, and consumer assistance in Colorado, Connecticut, Kentucky, and Washington as of Spring 2016. These states implemented the Medicaid expansion and established a state-based Marketplace (SBM) in 2014. This brief builds on previous reports that examined states’ preparation for implementation prior to the initial ACA open enrollment period and their experiences after completion of the first and second open enrollment periods.

September 18, 2016 Perspective

The Missing Debate Over Rising Health-Care Deductibles

In this Wall Street Journal Think Tank column, Drew Altman discusses what may be the most important change in the American health system—hint it’s not the Affordable Care Act—which has occurred without much discussion.

September 15, 2016 Report

Medicaid Coverage of Family Planning Benefits: Results from a State Survey

This survey of states’ Medicaid family planning policies under fee-for-service finds wide coverage of most prescription contraceptives among 40 states and the District of Columbia (DC), but variable coverage of emergency contraceptives and other family planning-related services. It is the first published report on state coverage of family planning benefits since the passage of the Affordable Care Act (ACA).

August 29, 2016 Perspective

The ACA Marketplace Problems in Context (and Why They Don’t Mean Obamacare Is ‘Failing’)

In this Wall Street Journal Think Tank column, Drew Altman discusses the latest challenges faced by the Affordable Care Act (ACA) marketplaces and why they should be kept in perspective: “If Obamacare had bipartisan support, they would be treated much more like mundane implementation issues to be addressed by Congress than glaring headlines about Obamacare failure.”

August 28, 2016 Issue Brief

Preliminary Data on Insurer Exits and Entrants in 2017 Affordable Care Act Marketplaces

This analysis provides a preliminary picture of the potential effect insurer exits and entrants may have on competition and consumer choice in the 2017 Affordable Care Act (ACA) marketplaces. Much is still unknown and the majority of states’ 2017 filings are either redacted or unavailable publicly.

August 18, 2016 Report

A Final Look: California’s Previously Uninsured after the ACA’s Third Open Enrollment Period

The Kaiser Family Foundation California Longitudinal Panel Survey is a series of surveys that, over time, tracked the experiences and views of a representative, randomly selected sample of Californians who were uninsured prior to the major coverage expansions under the Affordable Care Act (ACA). The initial baseline survey was conducted with a representative sample of 2,001 nonelderly uninsured Californian adults in summer 2013, prior to the ACA’s initial open enrollment period. After each enrollment period concluded, a survey was conducted of the same group of previously uninsured Californians who participated in the baseline (a longitudinal panel survey). The fourth and final survey in the series, and the focus of this report, followed up with them after the third open enrollment period in spring 2016 to find out whether more have gained coverage, lost coverage, or remained uninsured, what barriers to coverage remain, how those who now have insurance view their coverage, and to assess the impacts that gaining health insurance may have had on financial security and access to care.

August 17, 2016 Issue Brief

Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors

This brief explains three provisions of the Affordable Care Act (ACA) – risk adjustment, reinsurance, and risk corridors – that were intended to promote insurer competition on the basis of quality and value and promote insurance market stability, particularly in the early years of reform as the ACA marketplaces, also known as exchanges, were established.

August 14, 2016 Perspective

How Donald Trump’s Assertions About Obamacare Premium Increases Can’t Be True

In this Wall Street Journal Think Tank column, Drew Altman discusses why Donald Trump’s campaign trail claim that the Obama administration is withholding big Affordable Care Act premium increases until after the election to influence the outcome could not be true.