Sometime in the next few weeks, a federal appeals court is expected to decide whether the Affordable Care Act (ACA) is constitutional, a ruling that could have enormous consequences for millions of Arizonans.

Should the U.S. Court of Appeals for the 5th Circuit side with Arizona and the 19 other states that filed the lawsuit, they could repeal the ACA in its entirety. 

Such a ruling would cause 297,000 Arizonans to lose their health insurance, leading to a 38% increase in the state’s uninsured rate, according to Protect Our Care, a group focused on protecting healthcare.

Repeal of the ACA would also leave the nearly 2.8 million Arizonans who live with a pre-existing condition – such as asthma, diabetes and cancer – without patient protections, meaning insurance companies could once again deny them life-saving coverage. This includes 386,200 children, according to FamiliesUSA, a nonprofit, nonpartisan advocacy group for healthcare consumers.

The lawsuit, filed in 2018, marks just the latest attempt in the Trump administrations’ quest to overturn the ACA. 

Since sweeping into office in 2017, the Trump administration has cut back on advertising and enrollment assistance for the healthcare marketplace, repealed the ACA’s individual mandate, and most recently has aligned itself with the Republican states in their lawsuit to repeal the ACA.

While the ACA remains intact for now, attempts to undermine the law have already caused damage in Arizona.  

The state saw a “statistically significant” increase in the number of people without health insurance between 2017 and 2018, according to new data from the U.S. Census Bureau. 

750,000 Arizonans went without health insurance in 2018 — an increase of 55,000 people from 2017 — and 1 in 10 people in the state are now uninsured. Experts say that at least part of the increase is due to the Trump administration’s efforts to undermine the ACA.

The law had previously reduced Arizona’s uninsured rate from 18% in 2013 all the way down to 10% in 2017, before the uptick last year. 

If the ACA were repealed, that number would rise significantly. 

Older Arizonans would also suffer, as an estimated 94,100 seniors could see their prescription drug costs increase, while people over the age of 50 could find themselves being charged substantially more than younger Arizonans, resulting in an estimated $6,308 “age tax,” according to the AARP.

How will the Trump administration and Arizona handle the fall-out if the ACA were repealed? That remains increasingly unclear, as it appears there is no plan to replace the law, according to a recent report from the Washington Post. 

One thing seems clear though: If the healthcare law is repealed, it’s Arizonans who rely on the ACA for coverage and protections for pre-existing conditions who will suffer the consequences.