The future of the Affordable Care Act is threatened — again — this time by a ruling Friday from a federal district court judge in Texas.
Judge Reed C. O’Connor struck down the law, siding with a group of 18 Republican state attorneys general and two GOP governors who brought the case. O’Connor said the tax bill passed by Congress last December effectively rendered the entire health law unconstitutional.
That tax measure eliminated the penalty for not having insurance. An earlier Supreme Court decision upheld the ACA based on the view that the penalty was a tax and thus the law was valid because it relied on appropriate power allowed Congress under the Constitution. O’Connor’s decision said that without that penalty, the law no longer met that Constitutional test.
“In some ways, the question before the Court involves the intent of both the 2010 and 2017 Congresses,” O’Connor wrote in his 55-page decision. “The former enacted the ACA. The latter sawed off the last leg it stood on.”
The decision came just hours before the end of open enrollment for ACA plans in most states that use the federal Healthcare.gov insurance exchange. It is not expected that the ruling will impact the coverage for those people — the final decision will likely not come until the case reaches the Supreme Court again.
Seema Verma, the administrator of the Centers for Medicare & Medicaid Services, which oversees those insurance exchanges, said in a tweet: “The recent federal court decision is still moving through the courts, and the exchanges are still open for business and we will continue with open enrollment. There is no impact to current coverage or coverage in a 2019 plan.”
The 16 Democratic state attorneys general who intervened in the case to defend the health law immediately vowed to appeal.
“The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court,” said a statement from California Attorney General Xavier Becerra. “Today’s misguided ruling will not deter us: our coalition will continue to fight in court for the health and wellbeing of all Americans.”
It is all but certain the case will become the third time the Supreme Court decides a constitutional question related to the ACA. In addition to upholding the law in 2012, the court rejected another challenge to the law in 2015.
It is hard to overstate what would happen to the nation’s health care system if the decision is ultimately upheld. The Affordable Care Act touched almost every aspect of health care, from Medicare and Medicaid to generic biologic drugs, the Indian Health Service, and public health changes like calorie counts on menus.
The case, Texas v United States, was filed in February. The plaintiffs argued that because the Supreme Court upheld the ACA in 2012 as a constitutional use of its taxing power, the elimination of the tax makes the rest of the law unconstitutional.
In June, the Justice Department announced it would not fully defend the law in court. While the Trump administration said it did not agree with the plaintiffs that the tax law meant the entire ACA was unconstitutional, it said that the provisions of the law guaranteeing that people with preexisting health conditions could purchase coverage at the same price as everyone else were so inextricably linked to the tax penalty that they should be struck.
The administration urged the court to declare those provisions invalid beginning Jan. 1, 2019. That is the day the tax penalty for not having insurance disappears.
The protections for people with preexisting conditions was one of the top health issues in the midterm elections in November. While the issue mostly played to the advantage of Democrats, one of the Republican plaintiffs, Missouri Attorney General Josh Hawley, defeated Democratic incumbent Sen. Claire McCaskill. Another plaintiff, West Virginia Attorney General Patrick Morrisey, lost to Democratic incumbent Sen. Joe Manchin.
President Donald Trump was quick to take a victory lap, and pressed Senate Majority Leader Mitch McConnell (R-Ky.) and the presumed incoming House Speaker Nancy Pelosi (D-Calif.) to fix the problem. He tweeted Friday night that “As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!”
But congressional leaders were quick to point out that the suit is far from over.
“The ruling seems to be based on faulty legal reasoning and hopefully it will be overturned,” said a statement from Senate Minority Leader Chuck Schumer (D-N.Y.).
Many legal experts agreed with that. “This is insanity in print, and it will not stand up on appeal,” tweeted University of Michigan Law School Professor Nicholas Bagley, an expert in health law.
Even some conservatives were left scratching their heads. “Congress acted last year to repeal the mandate, but leave everything else in place and the courts should have deferred to that,” tweeted former congressional GOP aide Chris Jacobs.
–Julie Rovner, Kaiser Health News
Edith Campins says
So the Affordable Care Act isn’t unconstitutional in itself. The tax law, passedby the Republicans last December has made it unconstitutional. Got it. If yo can’t kill it one way try another. THe same tax law that gave the big break to the richest and the corporations.
It is the mark of a truly evil human being that trump rejoices in they “win” that could cost millions of Americans their healthcare. Where is the healthcare plan he promised? Just another lie.
Concerned Citizen says
Good for her and Justice O’Connor
Why should I be forced to have health care that is unaffordable? Why should I be fined for something that most of us probably can’t afford?
If you are going to mandate health care then make it so that individual incomes can afford it.
I am middle aged in relatively good health and last year 2 quotes I received were over 350 a month for a “basic plan”. I make decent money but still have rent, utilities, car payment and car insurance. I already pick up side work to make ends meet. I’m not working a second job to afford health care.
I’m still confused as to why the US can’t switch over to Universal Healthcare. It works in other countries.
palmcoaster says
One more attempt to do away with this minimal but effective right to provide some health insurance for young people that died or become disable not being able to afford preventive health care! At this point I would also lobby for all included Pam Bondi to be done away with their luxury health care plan that we are all forced fund for them in our taxes. In our supposedly democratic republic what makes them different to receive health care services with our tax funds versus the health care they tyrannically denied to millions of Americans younger than 67 years old? I keep the faith that our Supreme Court Justices and with Justice Roberts at the helm will not allow their ACA vote to be changed!!
palmcoaster says
That face above reminds me the same expression of “el Duce:.
for real says
Just got a notice from the IRS that I missed this on my tax. Just sent in a fine of like $1390.00 for not having health insurance. (my spouse as well). Two weeks ago.
So will thy send me my money back? Or use it to build the wall or some other wasteful expense? Will they refund all the other people who paid this as well?
I know they won’t, but just thinking!
Wonder how much they collected from this penalty.
Richard says
Here we go again! Lower court forces their opinion on the rest of the country then it ends up at the Supreme Court. Why not just skip the lower court and go directly to the top. Since healthcare and border security are the two top concerns of the American people, for the life of me why the hell is Congress so bent on NOT passing a bipartisan bill that would address both issues to the satisfaction of the American people? Well the answer to my question is that Congress is hell bent on destroying our sitting president in whatever way it can. They could care less about passing bills that help the people of this country. Eventually the voting public will shove it right up their rear ends like they did back in 2016. I wonder how many dem’s are now sorry that they voted in those democratic house representatives that ran their campaign on NOT allowing Pelosi to be Speaker of The House but lied just to get votes?
Shark says
Great – now we will all get that cheap health insurance, that we will all love, promised by drumpf.
Agkistrodon says
Requiring all to have health insurance is NO different then requiring ALL to have auto insurance, whether you have a license or automobile. If you do not think it is un-Constitutional you need to repeat US Civics, and pay attention the the Constitution part.
Trailer Bob says
For all of you who think some form of National Healthcare would work, just look no further than the Veterans Administrations, which is sort of like universal health insurance for veterans. I write this as I sit here in major pain because the VA will do all it can to avoid operation on me and fixing my 24/7 spinal pain. Do any of you really think that the US Government is capable of running healthcare? IF you want to see where the problem lies, check out the Kaiser Family Foundation website to see just how many babies are born who’s mothers are on welfare..sort of like 60%. These are births we are all paying for while the people getting regnant have no responsibility for their actions or choices.
Meh says
I think corporate welfare is a bigger problem. Maybe address that instead.
Agkistrodon says
@Trailer bob AMEN Bob. As someone who is a disabled vet, 100% BTW, I have to go to the VA. I would INVITE ANY one who is pro Universal healthcare to come with me to the VA a few times, See what I and OTHER vets get to see. See how we are treated. And if you don’t take the drugs they want to force on you, for things you don’t really have, they stop making your appointments. I currently have an impacted Molar I have had since September. It was repairable, but THEY waited too long and now it has to be extracted. It has been infected, drained, on antibiotics 5 times, and still is in my mouth! For the record with my 100%, I have FULL COVERAGE DENTAL, but only if they will get “to it”, Good QUALITY preventive care there……….And guess what If THEY get their way, VERY soon YOU could ALL have the very same thing.
Really says
No worries DonaldCare on the way