New York is part of a coalition of 20 states plus the District of Columbia backing the Affordable Care Act as the health care law once again faces a challenge in the U.S. Supreme Court.

A signature law for President Obama approved in 2009, the measure has withstood challenges before, but a key piece of the law requiring Americans to purchase health insurance was removed by Congress and President Donald Trump in 2017. 

Now a coalition led by Texas is challenging the measure's existence going forward.

“The Affordable Care Act has been the law of the land for a decade now, but President Trump, his administration, and Republicans allies are trying to take us backwards in time by stripping health coverage away from millions of Americans,” said New York Attorney General Letitia James.

It's not yet clear what would happen if the Supreme Court ruled to scrap the measure. New York was among the states that participated in the Medicaid expansion under the law and created an exchange marketplace for people to buy health insurance. Pre-existing conditions must be covered by health insurance under state law.

Democrats who control the state Legislature in New York would likely find ways of reconstituting aspects of the Affordable Care Act if it is ultimately scrapped. 

“Today, Donald Trump and Republicans fought to kick children off their parents’ health care plans, fought to rip health coverage away from the 133 million with pre-existing conditions, fought to charge women more for no other reason than being a woman, fought to increase the cost of prescription drugs for seniors, and fought to deprive millions of Americans access to quality, affordable health care," James said.

"Time after time, President Trump and his Republican allies have failed to get Congress to do its dirty work and has instead attempted to dismantle the ACA, piece-by-piece. We are confident the court will reject Republicans’ arguments today, just like it did in 2012, and that we will prevail in protecting Americans’ right to health care.”