What has the ACA accomplished?

When the Patient Protection and Affordable Care Act (ACA) was implemented in 2014, approximately 20 million additional Americans received coverage. The ACA contains many popular provisions like Medicaid expansion, marketplace subsidies, protections for those with pre-existing conditions, and allowing young adults to stay on their parent’s health insurance plan until age 26. The ACA also named ten “essential health benefits” that all insurance plans must have, including things like preventative and wellness visits, maternity and newborn care, lab tests, and pediatric care. While these provisions are the ones most commonly associated with the ACA, there are several lesser known, but very important, protections that will be lost if the ACA is repealed.

What’s at risk? 

In February 2018, Texas and a group of other states (including Tennessee) filed suit (Texas v. United States) against the federal government, arguing that the individual mandate provision of the ACA is unconstitutional after the Tax Cuts and Jobs Act set the shared responsibility payment at zero dollars. After the federal government declared that it would not defend the constitutionality of the ACA, another group of states led by California stepped in to defend the law. On July 9, 2019, the U.S. Court of Appeals for the 5th Circuit heard oral arguments in this case. On December 18, 2019, the court ruled that the individual mandate is unconstitutional and sent the case back to the Texas district court judge to decide whether the remaining provisions of the ACA are constitutional. The Supreme Court accepted the case (California v. Texas) and heard oral arguments in November, 2020. Nearly a year later, in June 2021, the Supreme Court dismissed the case to strike down the ACA.

In other words, the ACA still stands!

Before the ACA, insurance companies could – and often did – deny health insurance to millions of Americans with common conditions such as diabetes, asthma, cancer and even pregnancy. If the ACA was repealed, it would cause at least 526,000 Tennesseans and millions of people across the country (including children) to lose coverage, eliminate protections for pre-existing conditions, and cause prices to go up for everyone, especially older adults and women. Now that the latest assault on the ACA has come to pass without a repeal, it’s time for Tennessee’s elected officials to build on the ACA’s successes and make improvements that will make healthcare more affordable and accessible. 

Read more: How Would Repealing the ACA Affect TennCare and CoverKids?




For our clients and millions across the country, the Affordable Care Act is a critical safety net for their health. Throughout the years, the ACA has sustained attack after attack, and this moment is no different. Whether you or someone you know gained coverage they otherwise could not afford through the ACA, there is no denying the massive impact this program has had on this nation over the course of half a decade. Take a look at how the ACA helped our clients through the years, as we step into the future by learning from past experiences just how much we need to protect the ACA.

If you have been impacted by the ACA, we want to hear from you. Share your story by clicking on this link!


Stay up to date with the latest advocacy opportunities and action tools in our Action Center.