The US Supreme Court is set to hold hearings on California v. Texas in November, a case in which the plaintiffs hope the court will invalidate the Affordable Care Act (ACA) in its entirety. The Trump administration has filed briefs in support of the plaintiffs, a group of state attorneys general led by Texas. The plaintiffs contend that the ACA is unconstitutional in light of the elimination of the individual mandate penalties beginning in 2019. Another group of attorneys general, led by California’s attorney general, argue that the ACA remains constitutional and should rightfully stay in effect, regardless of the elimination of the individual mandate penalties.

Should the plaintiffs win the case and the ACA be invalidated, the implications would be widespread and affect virtually every corner of the health care system. In this analysis, we provide an overview of how overturning the ACA would affect average people and illustrative, hypothetical families in different circumstances. Should the law be overturned and its myriad consumer protections eliminated, the associated increases in household costs would fall heavily on families with moderate and low incomes losing federal subsidies to offset their medical costs and people with significant health care needs.