Affordable Care Act Repeal by State

This interactive allows users to see the harms that would result if the Affordable Care Act were repealed, with data for all 50 states and the District of Columbia.

Part of a Series

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.

The positions of American Progress, and our policy experts, are independent, and the findings and conclusions presented are those of American Progress alone. A full list of supporters is available here. American Progress would like to acknowledge the many generous supporters who make our work possible.


Nicole Rapfogel

Policy Analyst, Health

Emily Gee

Senior Vice President, Inclusive Growth

Mathew Brady

Senior Data Visualization Developer

Explore The Series

Sisters wait in line for a Senate Finance Committee hearing on the proposal to repeal and replace the Affordable Care Act, September 25, 2017. (Getty/Tom Williams/CQ Roll Call)

The U.S. Supreme Court heard oral arguments in California v. Texas, the Affordable Care Act (ACA) repeal lawsuit, on November 10, 2020. The case was brought by a number of Republican state attorneys general and supported by the Trump administration. President Donald Trump long pledged to appoint judges who would side with his administration’s political interests and rule to overturn the ACA. The death of Justice Ruth Bader Ginsburg—and the rushed process to attempt to replace her—dramatically heightened the chance that the court would strike down the law and upend its previous decisions to uphold it. Overturning the ACA would throw the nation’s health care system into chaos and be disastrous for the health and economic security of millions of Americans. The Center for American Progress provides coverage and analysis on the impact of the health care repeal lawsuit, including how it would harm people with preexisting conditions and disabilities, communities of color, women, young people, families, and low-income families.