COLUMBUS, Ohio – Twenty-nine percent of non-elderly adult Ohioans are at risk of losing their insurance because of pre-existing conditions – if a federal appeals court strikes down the Affordable Care Act, according to new research.

The Kaiser Family Foundation released estimates Friday showing 53.9 million Americans and just under 2 million Ohioans had a host of deniable conditions – from most forms of cancer in the past decade to mental health disorders, pregnancy, sleep apnea and arthritis. The foundation obtained information from the U.S. Census Bureau’s National Health Interview Survey.

Most adults with pre-existing conditions get insurance through work or Medicaid. The vulnerable population that could lose insurance would be those purchasing individual or family policies due to self-employment, divorce, aging off their parents’ policies, early retirement, job loss or getting a job and losing Medicaid, the foundation said.

In July, the 5th Circuit Court of Appeals heard arguments in Texas v. U.S., the latest lawsuit challenging Obamacare, including pre-existing conditions. Its decision is pending and will undoubtedly be appealed to the U.S. Supreme Court.

Eighteen states, including Texas, are suing over the ACA’s individual mandate, saying it’s unconstitutional and as a result, the entire law should be overturned. In the Tax Cuts and Jobs Act passed by Congress in 2017, the financial penalty for not having insurance was lowered to zero. The Trump administration agrees that the mandate is unconstitutional but doesn’t want the whole law thrown out -- just the pre-existing conditions protections and the individual mandate.

The trial court ruled that since Congress took the individual mandate penalty to zero, it ceases to be a constitutional exercise of its taxing power. It ruled the entire law must be nixed because when the ACA was enacted in 2010, the individual mandate was called “essential.”

Many legal scholars -- even conservative ones who oppose the ACA -- consider the trial court’s reasoning unsound and even “bizarre."

Ohio Attorney General Dave Yost and Montana Attorney General Tom Fox, both Republicans, together filed an amicus brief, arguing that the appellate court should reverse the lower court’s decision to strike the law: “The court’s decision, if affirmed, will deprive millions of non-elderly Ohioans and Montanans of coverage for pre-existing conditions. It will also negatively affect countless others who organized their affairs in reliance on the Act’s many unrelated provisions.”

Loren Anthes of the Cleveland-based health care think tank the Center for Community Solutions said he’s seen estimates showing nationwide, over 100 million people would lose insurance or coverage under Medicaid expansion. Others would be charged higher insurance premiums, such as women and elderly people.

Medicaid makes up 4 percent of the economy, he said. If Medicaid expansion – a key component of the ACA -- went away, “you’re talking about a sudden contraction of the economy by 1%,” he said.

“One percent doesn’t seem like a lot, but if you suck $5 billion out of the state’s second largest industry, anyone who works in health care – medical equipment providers, lab techs, people who drive people to appointments – it’s all disrupted.”