Pelosi and Schumer will bring on the pain.

The only Republican applauding the appalling and ridiculous decision by an extremist federal judge in Texas declaring the Affordable Care Act unconstitutional is Individual 1. The rest of them understand how much this screws them politically. They're well aware that they lost the 2018 election largely on the issue of health care, and now the ones still in office know they're on the hook for the promise they made to people that they would preserve all the protections in the ACA, particularly those for people with pre-existing conditions.

That's perhaps the most immediate and most frightening aspect of the ruling for the majority of Americans, 130 million of whom have pre-existing conditions, but if the law were really to disappear, that's just a part of what would be lost.

As many as 17 million people could lose their coverage in a single year. The 15 million people covered under Medicaid expansion could lose their coverage. The improvements to Medicare that have saved the program billions of dollars—and reduced prescription drug costs for seniors—would be erased. Young people wouldn't be able to stay on their parents' insurance until they're 26. The ban on annual and lifetime caps would be gone, and medical bankruptcies would escalate. Having lady parts would again cost women more than men, and being over age 50 would cost everyone more again. Limits on out-of-pocket costs would be gone. The tax credits that 9 million people are receiving to help them pay premiums would be gone.

So it's absolutely no wonder Republicans are freaking out. There are still the rabid Trumpists who will applaud letting it all burn down, and then the rest who recognize how bad this is for them, which will only end up in more GOP civil war. "It's all the downsides," a House Republican aide told Politico. "Politically, I don't think that it helps us at all." It really won't help them when Democrats start fighting back on the floor.