Twenty Democratic-led states plus the District of Columbia have asked the Supreme Court for expedited review of a lower court decision that puts the future of the Affordable Care Act at risk.

On Friday, Jan. 3, the states filed a 41-page petition seeking Supreme Court review of the lower court’s ruling this term. In order for this to happen, the petition recommends that the nine justices set the case for their regularly scheduled closed-door conference on Friday, Feb. 21 and schedule it for oral argument either on April 29, the last day the court is scheduled to hear arguments this term, or at a special sitting in May. If the court agrees, a ruling could occur by late June; if it declines to take up the case at this time, the litigation will continue into 2021, beyond the November 2020 election.

What exactly is at stake? As the Washington Post notes, a whole lot if opponents of the ACA prevail in their effort to overturn the law: expansion of Medicaid in three dozen states, insurance subsidies for millions of people with coverage through ACA marketplaces, the ability of young adults to stay on their parents’ insurance policies until they turn 26, and consumer protections for people with preexisting medical conditions.

Back in December, the 5^th U.S. Circuit Court of Appeals, in a divided ruling, struck down part of the ACA but sent the case back to a lower court for further review. The ruling had little immediate effect on consumers, but the states seeking Supreme Court intervention note that the uncertainty created by the lower courts’ actions has left both consumers and the health care industry adrift. It is that uncertainty they want to see addressed.

Protesters in a “Save the ACA” rally in Los Angeles, California on March 23, 2017. Photo Credit: Ronen Tivony – NurPhoto/ Getty Images

“The actions of the lower courts have cast doubt on hundreds of other statutory provisions that together regulate a substantial portion of the nation’s economy,” the petition states. “States, health insurers, and millions of Americans rely on those provisions when making important – indeed, life-changing – decisions.”

The House of Representatives joined with the coalition of states in asking the Supreme Court to take the case.

“Every day the Republicans’ anti-health care lawsuit is allowed to endure is a day that American families will be forced to live in uncertainty and fear,” House Speaker Nancy Pelosi said in a statement.

It is not known when the Supreme Court will decide whether it will take the case this term. For more information and background on the ACA lawsuit, please see CHN’s latest Human Needs Report.