Health Affairs  |  March 19, 2020

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The Affordable Care Act’s legacy extends beyond its provision of health insurance to millions of previously uninsured people and its improved consumer protections. It has also had a significant impact on the US legal system. Litigation over the law began on the day of its enactment and has been a constant in the decade since. Although the law has survived these challenges, its effectiveness has been hobbled. Litigation is now being used as a check on the efforts to undermine the Affordable Care Act by the administration of President Donald Trump. This article reviews the history of litigation over the Affordable Care Act, how the law generally has been shaped by this litigation, and what this experience might mean for the future of health reform efforts.

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