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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January 24, 2019 Report

The Health Care Priorities and Experiences of California Residents

This survey by the Kaiser Family Foundation and California Health Care Foundation gauges California residents’ views on health care priorities facing the state’s new governor and legislature, including health care affordability, access to care, mental health and substance use treatment, and provider shortages. It also highlights Californians’ experiences in the health care system, as well as views on the Affordable Care Act, Covered California, Medi-Cal, and proposals to advance a single-payer health insurance system in the state.

June 12, 2019 Issue Brief

Strategies for Improving Health Coverage and Reducing Costs: Major Proposals and Key Considerations

KFF’s Tricia Neuman’s testimony before the U.S. House Committee on Ways and Means on June 12, 2019 describes a range of proposals to broaden health insurance coverage and make health care more affordable, the similarities and differences among them, and the policy choices and trade-offs that could have significant implications for coverage and costs.

October 18, 2018 Poll Finding

KFF Election Tracking Poll: Health Care in the 2018 Midterms

In an expansive look at the 2018 midterm elections, this month’s KFF Health Tracking Poll includes an in-depth examination of the role health care may be playing in midterm elections nationally, as well as in Florida and Nevada, two bellwether states in which candidates from both parties are talking about health care issues. Health care remains a top priority for Democrats and independents, but ranks lower for Republicans, behind immigration and the economy and jobs. However, when it comes to specific health care issues, lowering health care costs and maintaining protections for pre-existing conditions have bipartisan support. In addition to exploring the role of health care issues in the election, the KFF Health Tracking Poll also finds large shares of voters say candidate characteristics, President Trump, and party control over Congress will be major factors in their voting decisions.

October 31, 2018 Issue Brief

Why Do Short-Term Health Insurance Plans Have Lower Premiums Than Plans That Comply with the ACA?

Short-term health insurance plans are able to charge premiums 54 percent lower than ACA-compliant plans, by excluding pre-existing conditions and severely limiting benefits.

February 20, 2019 Issue Brief

“Partial Medicaid Expansion” with ACA Enhanced Matching Funds: Implications for Financing and Coverage

The Affordable Care Act (ACA) provides enhanced federal matching funds to states that expand Medicaid to nonelderly adults up to 138% of the federal poverty level (FPL, $17,236/year for an individual in 2019). The ACA enhanced match (93% in 2019, and 90% in 2020 and thereafter) is substantially higher than states’ traditional Medicaid matching rate. A few states have sought Section 1115 demonstration waiver authority from the Centers for Medicare and Medicaid Services (CMS) to receive the substantially higher ACA enhanced match while limiting coverage to individuals at 100% FPL, instead of covering the full 138% FPL ACA group. To date, CMS has allowed states to receive the ACA enhanced Medicaid matching funds only if the entire expansion group is covered. CMS has not approved waiver requests seeking enhanced ACA matching funds for a partial coverage expansion in Arkansas or Massachusetts, while a request is pending in Utah. This brief explores the current rules for partial expansion and explains some of the potential implications for financing and coverage if CMS approves waivers to allow for partial expansion with enhanced matching funds.

April 15, 2019 Perspective

For Low-Income People, Employer Health Coverage is Worse Than ACA

In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

April 3, 2019 Perspective

Trump is Reading the Base Wrong on the Affordable Care Act

In this Axios column, co-written with MollyAnn Brodie, Drew Altman discusses GOP voters’ more nuanced views on the health law.

October 15, 2019 News Release

Poll: Democrats Say They Are Hearing Enough From Presidential Candidates About Medicare-for-All and Expanding Coverage, But Want Them to Talk More about Health Costs and Women’s Health Care

Heading into tonight’s Democratic primary debate, most Democrats and Democratic-leaning independents say the candidates are spending the right amount or too much time talking about ways to provide coverage to more Americans and Medicare-for-all, two topics that have dominated health care discussions in the past three rounds of Democratic debates,…

October 25, 2019 Fact Sheet

ACA Open Enrollment: For Consumers Considering Short-Term Policies

A short fact sheet provides information about short-term health insurance policies and how they differ from ACA-compliant plans.

December 2, 2019 News Release

New Resource Outlines Efforts to Expand Screening and Counseling for Intimate Partner Violence

Two resources give an overview of intimate partner violence (IPV) in the U.S. and insurance coverage for screening and counseling.