The 2018 midterm elections meant the end of the GOP’s decade-long efforts to repeal the Affordable Care Act.

With Democrats in control of the House, the ACA has survived.

But it’s wounded. And it still faces grave uncertainty from the lawsuit brought by conservative states and backed in part by the Trump Administration’s Department of Justice. A federal judge in December 2018 ruled that the entire law – each and every provision – should be thrown out now that Congress has eliminated the individual mandate penalty. Most legal experts doubt that will be upheld but pieces of the law, including the popular protections for people with pre-existing conditions, could be in jeopardy. The appeals process could take months if not years, adding more damaging questions about the ACA’s future.

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