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Given that she lives in one of the few states that hasn’t expanded Medicaid under the ACA, Horstman said that she doesn’t trust the state legislature to fund the program if congressional Republicans pull back federal dollars.

That rate fell from 16% when the ACA was passed to about 8% now.

Many middle-income households got subsidies for the first time after Congress expanded them in 2021, which helped generate a boom in enrollment in ACA exchanges nationwide.

The Supreme Court decisively slapped O’Connor down with a 7-2 ruling upholding the ACA’s constitutionality in 2021.

Ignoring the Supreme Court’s signal, O’Connor subsequently ruled that the ACA’s provision for no-cost preventive services was also unconstitutional.