For many Americans, the future of health insurance coverage is uncertain. The fate of nearly 20 million people could lie in the hands of just a few individuals: the nine Justices that make up the United States Supreme Court. Since his 2016 campaign, President Trump has been vocal about his commitment to overturning the Affordable Care Act, also known as Obamacare, and his continuous attacks on the ACA have persisted to this day. In this case what happens if the Affordable Care Act repealed The Trump Administration is suing to overturn the law in the Supreme Court, claiming that it is unconstitutional. Oral hearings for the case are set to begin on November 10, 2020.

Now, as the November general election looms, the Trump administration is rushing to fill the Supreme Court’s ninth seat – newly vacant after the death of Ruth Bader Ginsburg  – with a conservative nominee. If successful, the move would cause a 6-3 conservative majority, and Trump’s dream of overturning Obamacare could become a reality.

It’s safe to say that the implications of the Supreme Court’s decision would be far and wide, but you might be wondering what the Affordable Care Act Repealed would look like going forward. Read on to learn more about what experts say could happen if the ACA is repealed.

1. 20 million Americans could lose insurance coverage

If Obamacare is overturned, the Urban Institute estimates that the number of uninsured people would increase by nearly 20 million people or 65 percent. As other experts have noted, this number could be even higher in the midst of the coronavirus pandemic, when millions of Americans have lost their jobs and their employer-sponsored insurance coverage at historic levels.

2. You could be denied coverage for preexisting conditions

Under the Affordable Care Act, insurers cannot discriminate against consumers based on their medical history. This means they can’t deny coverage or even charge higher rates. In 2018, Trump’s Department of Justice filed a brief to strike down the ACA’s protections for preexisting conditions, showing us what might happen if the Supreme Court does repeal the ACA. In a country where it’s estimated that 130 million people qualify as having preexisting conditions, overturning Obamacare would have dire consequences.

3. Health care costs would rise

Obamacare offers tax credits that reduce premiums and out-of-pocket expenses for millions of families. Without the ACA, insurers could also implement annual and lifetime limits on coverage again, including for people with employer plans, and reinstate cost-sharing for preventive services

4. 1.2 million jobs could be lost

The Urban Institute estimates that the financial difficulties caused by repealing the ACA would have a ripple effect throughout the economy. If health care costs increase, that means millions of Americans will have less spending money on necessities like food and rent. 1.2 million jobs could be lost.

5. Coverage loss would differ along racial lines

While millions stand to lose coverage if Obamacare is overturned, experts say that the Supreme Court decision would not affect all Americans equally. It’s estimated that 1 in 16 white individuals will lose coverage, compared to 1 in 10 black individuals and 1 in 3 Hispanic people.

6. Medicaid could see changes, too

The ACA Marketplace isn’t the only place where coverage would change. The ACA grants States the ability to expand their Medicaid services to adults with incomes below 138 percent of the poverty line. Repealing the law could cause the 13 million people who’ve benefited from this to lose their coverage. The ACA also streamlined states’ Medicaid eligibility processing, and without it, the process could return to its more complicated form.

7. Prescription drug costs could rise for Medicare recipients

Medicare is another area in which consumers could see major disruption. Known as the “donut hole,” most Medicare plans had a coverage gap that temporarily limited what the plan would cover for drug prescriptions. Before implementing the Affordable Care Act, consumers had to pay the cost of medication once they reached their annual drug-spending limit. The ACA slowly decreased the donut hole, and in 2020, consumers only have to pay 25% of the costs of prescriptions once the spending limit is reached. Without the ACA, many senior citizens will have increased difficulty when trying to afford prescription drugs.

8. Young people might lose coverage

The Affordable Care Act requires insurers to offer coverage to dependent children until age 26. This applies to both Marketplace and employer-provided plans. Without the ACA, insurers could stop covering children at 19, or when they are no longer a full-time student.

9. Employers might stop offering health insurance

The employer mandate provision of the ACA requires employers with 50 or more full-time employees to offer “affordable” health insurance to at least 95% of their employees. Affordability is decided by whether the employee’s contributions exceed a certain percentage of their household income. Employers who do not offer coverage, or who offer unaffordable coverage, see a penalty. Many employers could drop their offerings if the Supreme Court repeals the Affordable Care Act.


The death of Ruth Bader Ginsburg has come at a pivotal time for our country, and only time will tell how the changes in the makeup of the Supreme Court will affect future generations. The prospect of the Affordable Care Act repealed might be frightening for many – but don’t lose hope! Voting and contacting your representatives are important ways for you to make sure your voice is heard

Photo by Andrea Piacquadio from Pexels


Photo: Patient Protection and Affordable Care Act with stethoscope by Marco Verch under Creative Commons 2.0
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