The U.S. Supreme Court acknowledged how much is at stake in the Texas v. United States health care repeal lawsuit and agreed to hear the case this fall. The repeal lawsuit—initiated by Republican state attorneys general and governors and supported by the Trump administration—is based on a legal theory that scholars have called “absurd” and “ludicrous.” But a Texas district court judge agreed and ruled that the Affordable Care Act (ACA) must be struck down in its entirety.

If the Supreme Court upholds the lower court’s ruling, millions of Americans will lose coverage and pay significantly more for health care. People with preexisting conditions will once again face discrimination from insurance companies, and millionaires and billionaires will receive even more in tax cuts.

Before taking office, President Donald Trump claimed that “everybody’s got to be covered” by health insurance and promised to lower out-of-pocket costs. In reality, his administration has worked relentlessly to strip health care from millions of Americans and gut protections for people with preexisting conditions. After coming up one vote short in its attempt to repeal the ACA in Congress in 2017, the administration shifted strategies, putting the weight of the U.S. Department of Justice behind the latest partisan effort to strike down the law.

A ruling that invalidates the ACA or eliminates core features of the law would have a devastating effect on American families. Select your state from the drop-down list below to see some of the harms that would result from ACA repeal.

Nicole Rapfogel is a research assistant for Health Policy at the Center for American Progress. Emily Gee is the health economist of Health Policy at the Center. Mathew Brady is the data visualization developer at the Center.

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