Several states are working on their own healthcare plans to preserve some coverage and provisions of the Affordable Care Act as the healthcare law makes its way through an appeals court and faces the real possibility of being overturned, The Wall Street Journal reported.

In the absence of a Trump administration healthcare plan to replace the ACA, a huge gap in insurance could be in the future. The ACA is facing its biggest legal challenge to date after a Republican-led lawsuit sought to overturn it and a federal judge declared the entire law unconstitutional last year. While Democrats have appealed the decision, the ACA remains the law of the land.

Some lawmakers in a handful of states, including Louisiana, Nevada, New Mexico and California, have approved legislation or are reviewing action to deal with the possibility that the ACA could be tossed out soon, the WSJ reported. The plans include providing subsidies to high-cost patients, coverage gap solutions and rules to prevent people from being denied coverage.

Part of the motivation by these lawmakers to provide assurance that their constituents would be able to find health insurance in the case that the ACA were to be tossed are tight re-election campaigns, according to the WSJ.

Under the ACA provisions, people with pre-existing conditions cannot be denied health insurance coverage or be forced to pay more for their plan. Those protections would go away if the ACA is invalidated, exposing up to 54 million Americans with a pre-existing condition, according to one estimate.

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