By Maanasa Kona and Sabrina Corlette

On November 10th, the Supreme Court will hear oral arguments in California v. Texas, a lawsuit filed by Republican attorneys general that argues, with the support of the Trump administration, that the entirety of the Affordable Care Act (ACA), including its protections for people with preexisting conditions, should be invalidated. While the Trump administration has repeatedly claimed to support people with preexisting conditions, there is no existing plan that would meaningfully retain these protections if the ACA is overturned.

Prior to the ACA, it was largely up to states to regulate insurance companies, and most states had very limited protections in place. In response to recent efforts to repeal and invalidate the ACA, a significant number of states have passed their own laws, with the goal of protecting people with preexisting conditions. However, in our latest analysis of state laws for the Commonwealth Fund’s To the Point blog, we find that the majority of states would leave residents exposed to discrimination by insurers if the ACA is struck down. And, even when a state has adopted all four protections, without financial help from the federal government to make coverage affordable, the individual health insurance market will become dysfunctional, with fewer plans participating and spiraling premiums. To read our full analysis and view a table of laws in all 50 states and D.C., visit the To the Point blog here.