If you’re celebrating a recent federal appellate court ruling that overturned language in the Affordable Care Act requiring you to have health insurance or pay a penalty, you may want to put away the party favors.

That’s because, like a Pandora’s box, the ruling by the New Orleans-based 5th Circuit Court of Appeals now puts at risk other parts of the 2009 law at risk, like the ban on denying coverage to people with preexisting conditions and language allowing young people to stay on their parents’ insurance until they’re 26 years old.

Why? Because the appellate court returned the case to a federal court judge in Texas, who earlier declared the entire law unconstitutional, effectively starting the clock over again.

Legal experts say this “remand and delay strategy,” likely guarantees the Affordable Care Act will end up before a U.S. Supreme Court that’s even more conservative than it is now, multiplying the chances the whole law will be declared unconstitutional by the nation’s highest court.

If you’re thinking “Oh that won’t affect me, I get coverage through my employer,” think again.

According to the Urban Institute, a Supreme Court ruling overturning the Affordable Care Act will impact every American who has health insurance – whether through work, Medicare or Medicaid.

A recent study by the left-leaning Center for American Progress drove home the effect in real numbers:

– More than 130 million Americans, according to CAP, have preexisting conditions. They could end up paying more or being denied coverage entirely.

– Overturning the healthcare law would mean that 45,600 people in every congressional district in the country would lose coverage.

– States would lose $135 billion in federal funding for people enrolled in Medicaid and marketplace financial assistance “in 2019 alone.” That means those costs would either be passed along to taxpayers, or, more likely, people would be dropped from the rolls.

And in the short term, the appellate court’s ruling “will harm insurance markets, driving premium increases,” said Topher Spiro, CAP’s vice president for healthcare policy, which will spike “needless anxiety and suffering for patients.”

It’s worth pausing to note the law’s Republican opponents in Congress, abetted by the GOP attorneys general who brought the original Texas lawsuit, don’t have a Plan B. So as much as the debate over the Affordable Care Act is a legal issue, it’s a political one as well.

And right now – public opinion is on the law’s side.

Fifty-two percent of respondents to a Kaiser Family Foundation poll in November said they had a favorable opinion of the law, compared to 41 percent who had a negative opinion. Unsurprisingly, Democratic support ran strongest at 83 percent, pollsters found, while barely 2 in 10 Republicans (22 percent) said the same.

Tellingly, however, a clear majority of independents (52 percent) said they had a favorable opinion of the law – and that’s a constituency that both Democrats and Republicans will be vying for in 2020.

For now, the Affordable Care Act also continues to poll better than Medicare for All, which is embraced by Democratic presidential candidates Sen. Bernie Sanders and Sen. Elizabeth Warren. Depending on how it’s described, public support for a federally run, single-payer program charts at 47 to 48 percent, that same Kaiser Family Foundation poll found.

A decade on from its creation, the Affordable Care Act is a bedrock part of the American healthcare landscape.

And while some may object to it conceptually, it’s a certainty that most Americans would not want to return to those pre-2009 days of pre-existing condition coverage denials and exploding uncompensated care costs for hospitals.

It’s not perfect. But it’s better than nothing at all. And nothing is exactly what the law’s foes want to return to – and that can’t ever be allowed to happen.

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