The Affordable Care Act is in serious danger if Trump replaces Ginsburg

A sizable anti-abortion minority of U.S. voters are excited at the prospect of a 6-3 conservative Supreme Court striking down or effectively neutering Roe v. Wade, but the Affordable Care Act is in much more imminent danger after the death Friday of Justice Ruth Bader Ginsburg.

The high court is scheduled to hear oral arguments Nov. 10 in a lawsuit by Texas and other conservative states, backed by the Trump administration, arguing that the entire ACA should be struck down because the GOP-controlled Congress zeroed out the individual mandate to buy insurance in 2017. The lawsuit "was largely shrugged off" when it was filed two years ago, Politico notes, but it has now "been validated by Republican-appointed justices in lower courts, and ObamaCare will have one less ally on the conservative-dominated bench when the Supreme Court considers the law's fate this fall."

"Conventional wisdom had held that Chief Justice John Roberts would likely join with the court's liberals to save the ACA once again," Axios reports. "But if President Trump is able to fill Ginsburg's former seat, Roberts' vote alone wouldn't be enough to do the trick, and the law — or big sections of it — is more likely to be struck down." Most at risk are the law's protections for pre-existing conditions, according to legal scholars following the litigation. But everything is on the table, including Medicaid expansion, coverage for people up to age 26 on their parents' insurance plans, and no-cost preventative care.

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"A broad ruling against the entire ACA still requires some logical leaps," Axios notes. But "a lawsuit that once seemed like a long shot now has a much more reasonable chance at success — and that means 20 million people's health coverage really could be in the balance." Trump and congressional Republicans tried and narrowly failed to replace the ACA in 2017, and Trump has yet to release his frequently teased newer health care plan.