This week, the U.S. Supreme Court turned down a request to hear an expedited challenge to the Affordable Care Act (ACA). The request for an expedited final decision from the high court was led by the California Attorney General following a December 2019 court of appeals ruling that struck down the ACA’s health insurance mandate; the question of whether the rest of the law can stand was sent back to a lower court in Texas, presided over by Judge Reed O’Connor, who ruled against the entire ACA in 2018. Because it could take the lower court up to a year to make its ruling, the states supporting the ACA submitted the expedited request to the Supreme Court, hoping the high court would issue a final ruling prior to the 2020 election.

The fate of the ACA and the millions of Americans insured under it will remain in question while the case works its way through the courts. If Judge O’Connor rules against the law again, Democratic states will likely appeal that decision, so it is expected that the ACA ultimately will go before the Supreme Court. In the meantime, neither the December 2019 ruling nor the Supreme Court’s refusal to hear it affects current ACA coverage and patient protections.

The Supreme Court did not provide a comment with its decision not to hear the case.