Researchers estimate that federal health-care spending would fall $152 billion annually and the amount of uncompensated care sought by the uninsured would rise 74%. (Photo: Diego M. Radzinschi)
The fate of the Affordable Care Act was front and center during confirmation hearings for Amy Coney Barrett last week. The U.S. Supreme Court is scheduled to hear oral arguments about the constitutionality of the act in California v. Texas in November.
The uninsurance rate for nonelderly people in the United States would climb nearly 70% in 2022 if the ACA is overturned, according to a new study, "The Potential Effects of a Supreme Court Decision to Overturn the Affordable Care Act," updating previous results by researchers at the Urban Institute, with funding from the Robert Wood Johnson Foundation. As a result, more than 21 million individuals – one million more than prior estimates – could lose their health insurance coverage.
Recommended For You
Researchers predict disproportionate coverage losses among certain racial and ethnic groups if the ACA is overturned. Among both non-Hispanic Black and white people, the uninsurance rate is expected to increase nearly 85% (to 20% of Blacks and 15% of whites). Among Hispanic people, the increase would be nearly 40% (to 30%). Low-income people in states that expanded Medicaid eligibility requirements also would be disproportionately affected. Maine, Kentucky, and West Virginia would see their uninsurance rates nearly triple.
The study indicates federal health-care spending would fall $152 billion annually and the amount of uncompensated care sought by the uninsured would rise 74%.
Researchers utilized the Urban Institute's Health Insurance Policy Simulation Model to arrive at their findings. HIPSM is a comprehensive microsimulation model of the health insurance system that allows researchers to estimate cost and coverage implications of health policy decisions with real-world data. The model is regularly updated with recent data on Medicaid and marketplace enrollment, in addition to economic and employment data. The model is widely cited, notably in previous Supreme Court rulings related to the ACA. This analysis takes into account projections that the United States will have partially recovered from the COVID recession as of 2022.
"Invalidating the ACA would be devastating to millions, especially people who gained access to affordable health coverage in the past decade," said Avenel Joseph, PhD, vice president for policy at the Robert Wood Johnson Foundation. "Nearly overnight, America's health-care system could become more expensive and less accessible, and perpetuate health and financial insecurity. Unfortunately, those who have the least stand to lose the most."
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
Alan Goforth
Alan Goforth is a freelance writer in suburban Kansas City. In addition to freelancing for several publications, he has written a dozen books about sports and other topics.
