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Millions of Young People at Risk of Losing Coverage as Fifth Circuit Court of Appeals hears arguments in Texas vs. US

Like the proverbial cat, the Affordable Care Act (ACA) seems to have nine lives – from its initial passage just squeaking through Congress in 2010, to the more than 70 unsuccessful attempts to repeal the law. It survived two high stakes Supreme Court challenges, and two presidential elections, the last of which seemed to ensure the ACA’s doom, only to survive again thanks to activists across the country who made their voices heard. Despite this incredible resilience, here we are again – facing an all-out threat to the ACA in the courts.

On July 9th, the U.S. Court of Appeals for the Fifth Circuit will hear oral arguments in a case that, if successful, would strike down the entire ACA. The plaintiffs who brought the case, 18 Republican state Attorneys General led by Texas’s AG Ken Paxton, are arguing that the ACA is unconstitutional. This is because Congress, after a year of trying to repeal the ACA, zeroed out the individual mandate – which required everyone to sign up for coverage or face a penalty fee. The Republican Attorneys General think this makes the mandate unconstitutional. If the mandate is unconstitutional, they argue, the rest of the law is invalid too. 

Normally, the federal government does the job of defending federal law. But, in a stunning decision, the Trump administration agreed with the Republican attorneys general and has asked the Fifth Circuit to invalidate the ACA. That leaves defending the ACA to 21 Democratic attorneys general, led by California’s Attorney General Xavier Becerra, and the House of Representatives, led by Speaker Nancy Pelosi, who stepped in on behalf of millions of people nationwide who rely on the ACA.

This case started in a federal district court in Texas, where the judge ruled in favor of the plaintiffs, meaning he ruled to strike down the entire law. The judge in that district court, Judge Reed O’Connor, issued his ruling on December 14, the day before the end of the most recent annual ACA open enrollment period –  unsurprisingly causing some confusion. While this ruling caused some panic on the heels of open enrollment, the court also ordered an injunction – meaning nothing would change immediately – and the ACA would remain the law of the land while the case made its way through the appeals process. 

This is a really important point to note – nothing is changing now, and you should still pay your premiums, use your health insurance, and know that the ACA is in place until we hear fully and finally from the Supreme Court.

So why is this case so important to young people? Because it could repeal the entire ACA without replacing it with anything new. That would put the coverage of over 8 million young adults and improved benefits for millions more at risk and wreak havoc on the health care system. It would mean:

  • Young people could no longer to stay on their parents’ insurance through age 26 
  • Medicaid expansion, which covers 12 million Americans, would be eliminated 
  • Financial help through the marketplace for over 10 million people would be gone
  • Insurers could go back to charging you more for being a woman or deny coverage based on your health or medical history – jeopardizing coverage for the estimated 30 million young adults who have a pre-existing condition 
  • Insurers could reinstate annual and lifetime limits on care – meaning you could “max out” of coverage benefits and be on the hook for all your medical expenses 
  • Ultimately, 20 million people, many of them low-income people, would lose access to their health coverage

So what can we do to make sure our voices are heard? Sharing stories about how the ACA has impacted your life, the need to keep protections against pre-existing condition discrimination, and maintaining access to subsidies to afford coverage can be a powerful way to keep this story in the media. 

And while the House has intervened to defend the law, not one Republican member has joined the fight. If your House Representative hasn’t spoken up against this case, call them, email them, tag them on social media and ask them – why not? 

To stay updated as this case develops, be sure to sign up for Young Invincibles’ health updates, and follow us on all social media platforms. Still have questions about this case? Want to learn more about how you can get involved and fight back? Email us at