Implications of the Fifth Circuit Court Decision in Texas v. United States

This report identifies the states and people who would face the largest coverage losses if the Affordable Care Act (ACA) were repealed, and includes new estimates by city. It also estimates that total health care spending by the nonelderly population under an ACA repeal would fall by $94.6 billion (5 percent) in 2019 dollars, and that the cost of uncompensated care sought by uninsured people would nearly double, climbing by about $50 billion in 2019.

A recent U.S. Court of Appeals for the Fifth Circuit ruling makes it likely that the constitutionality of the ACA will be reviewed by the Supreme Court.