Editor’s note: This is part of an ongoing series highlighting the local impact of Trump’s policies in key counties in MI, PA, WI, and FL.

An ongoing lawsuit — supported by President Trump — currently working its way through a circuit court in Texas has the potential to dismantle the Affordable Care Act in its entirety, potentially skyrocketing prescription drug and premiums costs and stripping millions of Americans off their health coverage. In Marquette County, Wisconsin, the potential ramifications of this lawsuit could be catastrophic.

During the 2019 open enrollment period, nearly 5% of Marquette County residents — which has a total population of approximately 15,000 — enrolled in an ACA plan through the healthcare exchanges. Of those residents, more than 85% received tax credits and cost sharing subsidies to help curb the cost of rising prescription drug prices and insurance premiums.

According to HealthCare.gov, the subsidies cover $512 of a $612 monthly premium for millions insured under the ACA or its Medicaid expansion law. If the lawsuit is successful, most enrolled could no longer afford premiums at this rate.

A January 2019 analysis by the Associated Press found that every price cut for a brand-name drug in early 2018 was matched with a 96% increase in another drug, debunking the President’s theory that drug prices have decreased during the first-term of his administration. If the ACA is struck down, Wisconsinites could lose up to $1,137 per year in prescription drug discounts.

The lawsuit was filed in 2018 by a group of 18 Republican attorneys general and 2 Republican governors, after the Trump Administration attempted — and failed — to push a full repeal of the Affordable Care Act through Congress. It is being considered by a panel of three judges — two of whom are Republicans — on the 5th U.S. Circuit Court of Appeals.

The verdict reached will make or break crucial components of the law, including regulations protecting people with pre-existing conditions, and the ACA’s Medicaid expansion which covers approximately 12 million Americans.

“Remember that the kinds of provisions here that would be struck down if there’s no severability are, for example, the provision about when you can be denied or charged more insurance for preexisting conditions,” Attorney Douglas Letter said during a hearing in July.

In March 2019, Trump’s own Justice Department filed a legal brief arguing that the Affordable Care Act should be found unconstitutional. In June 2018, nearly 200,000 Wisconsinites were enrolled in the Affordable Care Act.

Wisconsin will serve as a key state the President will have to retake in order to win the presidency again in 2020. In 2018, the state flipped back blue, voting to elect Democratic Governor Tony Evers. The President’s approval in Wisconsin is currently underwater, resting at a tepid 41%.

Trump’s path to victory runs right through swing counties like Marquette, who voted for Trump in 2016 after previously voting to elect Barack Obama. In 2020, it remains unclear if Marquette County residents, and the people of Wisconsin, will make their opinions on the President’s history of attempting to dismantle the Affordable Care Act known at the ballot box.