The future of health care in the U.S. is on the edge of a cliff. It is a most serious moment and every citizen should be informed and demand our political candidates answer tough questions. We could be in a dark hole in a short time.

To the surprise of many, the future of health care in the U.S will be determined by a lawsuit before the U.S. Supreme Court .The lawsuit’s proponents consist of a coalition of 18 states, led by the attorney general of Texas, who want to overturn all of the Affordable Care Act (Obamacare). The suit’s opponents consist of a coalition of 20 states, led by the attorney general of California. The Supreme Court has agreed to hear arguments in the case. These arguments have been scheduled by the court for Nov. 10, one week after the election. A decision will likely be announced in late spring 2021. It has the potential of being a blockbuster. The passing of Justice Ruth Bader Ginsburg is a dark cloud on the horizon.

The ACA, passed by Congress in 2009 and enacted into law in 2014, has created many parts of the health care system in the U.S. as we know it. For example, it protects people with pre-existing conditions; it allows parents to keep their children up to age 26 on their insurance plan, and it eliminates out-of-pocket costs for preventative services. The law is popular, but there have been efforts to overturn it. Those who believe that total repeal should happen are organized.

If the court upholds the lawsuit in its entirety, all features and benefits of the ACA will be repealed. The lawsuit’s proponents are offering no replacement. President Trump has no plan. No one can predict what will happen. The prospect of significant chaos and frightening uncertainty for many individuals and families is real. On the other hand, if the court does not uphold the lawsuit, the proposal for total repeal will be rejected. The court could decide to retain some parts of the ACA and eliminate others. We will learn about this prospect when the court’s decision is announced. A continuation of the status quo could prevail, unless Congress and the White House vote for changes. Here is where the elections can make a difference. There will still be active debate on how to solve many of the problems with health care. The efforts to repeal the existing law will not go away.

Everyone in the nation will be affected by the court’s decision. It’s essential to understand the position of elected leaders on health care, their potential votes and their attempts to influence the outcome right now. As voters, we need to know how the candidates feel about health care issues and how they would likely vote to either eliminate the ACA or retain it. The consequences are tied to our health and our pocketbooks.

Voters in Maine need to know how the lawsuit before the Supreme Court would affect us and what candidates are saying. If the lawsuit is successful and Obamacare is fully or mostly repealed, close to 100,000 Mainers would lose insurance and Medicaid expansion would be eliminated. Increases in premiums could be expected.

President Trump has filed a brief with the Supreme Court advocating for complete repeal. He claims support for coverage of pre-existing conditions, but he has not presented a plan to do so. His Democratic opponent, Joe Biden, favors strengthening existing law and adding a public health insurance option.

Republican Sen. Susan Collins has advocated for retention of coverage for pre-existing conditions but has not revealed how this would be achieved or whether she supports the ACA repeal lawsuit. Democrat Sara Gideon has proposed strengthening Obamacare and favors a plan to reduce costs by allowing Americans to choose to buy into Medicare through a newly created option while preserving a choice for private insurance.

Voters have the power to influence the future of health care in this state and the nation. The outcome of the elections and the Supreme Court decision will determine if we fall off the cliff or work to improve what we have.