After failing to torpedo in Congress the huge health care reforms passed by former president Barack Obama, which has extended coverage for millions of Americans, President Donald Trump is counting on the Supreme Court to kill the bill, something he promised to do on the campaign trail in 2016.

Obamacare, or the Affordable Care Act (ACA), as the reform bill is officially known, is one of several key issues hanging in the balance in the November 3 election.

The text of the bill has already been scrutinized by the Supreme Court, which backed it by a small majority. It is due to go back to the Court again on November 10, a week after the election.

Without Ginsburg’s progressive vote, Obamacare could be scrapped entirely, including the obligation for insurers to cover pre-existing medical conditions.

The other goal of the Republican administration is to overturn the historic Roe v. Wade ruling that in 1973 legalized abortion.

Once for abortion rights, Trump is now an avowed opponent. The topic is close to the hearts of his religious-right base.

In recent years, several conservative states have been working to undermine the ruling, making it difficult for women to have access to abortions. Until now, the Supreme Court has blocked all of these efforts.

If Trump manages to push his candidate through, there will be a majority of six conservative justices out of nine on the bench, and the anti-abortion lobby will have more room to maneuver in its constant push to finally end Roe v. Wade.

Trump has pledged to defend the Second Amendment, which gives Americans the right to bear arms.

Some Americans want to see controls on gun sales and an outright ban on semi-automatic assault rifles that have been used in multiple mass shootings.

The Democrat-run state of Virginia recently voted to limit gun sales and strengthen background checks for buyers.

But millions of gun owners, as well as the powerful National Rifle Association lobby group, are fiercely opposed to any federal regulation on firearm sales.

Until now, the court has been reluctant to wade into the debate, declining to study the different cases sent before it. But here again, a strong conservative majority could swing any future decisions in favor of gun owners.

Religious freedom versus gay rights has become a hot-button issue in recent years, with the court showing itself more conservative on the subject. It ruled in favor of a Christian baker who refused to bake a wedding cake for a gay couple because of his religious convictions.

In November, the court will hear arguments from a Catholic adoption agency which had its license pulled by the city of Philadelphia for refusing to take on gay couples.

In the middle of the coronavirus pandemic, people in several states are already allowed to cast their votes, be it via early voting or mail-in ballots, and the question of the outcome of the bitterly fought November 3 election is uppermost in the minds of most Americans.

Yet Trump has been undermining confidence in the process for months, warning without proof of fraud and saying the only way he could lose is if the election is rigged.

Crucially, it is the Supreme Court which will settle any claims about a disputed outcome, as it did in Florida in 2000 when it decided in favor of Republican George W. Bush over Democrat Al Gore a month after the election.