A US federal judge in Texas has ruled that the Affordable Care Act – also known as “Obamacare” – is unconstitutional.
The landmark healthcare act could be headed back to the Supreme Court for the third time.
What Is The Affordable Care Act?
The law, introduced by President Barack Obama in 2010, aimed to make healthcare more widely available and affordable for Americans who could not afford the vital cover.
How Many People Are Covered?
About 20 million people have gained health insurance coverage since the ACA passed in 2010 without a single Republican vote.
What Does The Ruling Say?
In a 55-page judgement, US District Judge Reed O’Connor ruled that last year’s tax cut bill knocked the constitutional foundation from under the ACA by removing a penalty for not having coverage.
The rest of the law cannot be separated from that provision and is therefore invalid, he wrote, but supporters of the bill immediately said they would appeal.
The lawsuit was brought in February by Republican officials in 20 states.
Texas Attorney General Ken Paxton and his Wisconsin counterpart Brad Schimel – both Republicans – led the legal challenge.
What Does The Ruling Mean For Those Covered?
It is a severe blow to the American healthcare system.
If the ruling stands, the ACA’s insurance regulations would disappear and, along with them, the health coverage for millions of people who gained private insurance or Medicaid coverage - insurance which was expanded under Obamacare.
Legal expert Timothy Jost, a supporter of the health law, said O’Connor’s ruling would have repercussions for nearly all Americans if it stands.
If the entire health law is invalidated, popular provisions that benefit Medicare beneficiaries and people with employer coverage would also be scrapped. That could include the section that allows parents to keep young adult children on their coverage until age 26.
It also would eradicate one of Obama’s most significant accomplishments. According to an analysis by the Urban Institute, eliminating the Affordable Care Act would increase the national uninsured rate by 50 percent and lead to more than 17 million people losing health coverage.
Currently, about 10 million have subsidised private insurance through the health law’s insurance markets.
What Has The Reaction Been?
President Donald Trump said the ruling was “great news for America”.
“As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster!” he tweeted.
“Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions.”
But California Attorney General Xavier Becerra, who is leading a coalition of states defending the ACA, said: “Today’s misguided ruling will not deter us: our coalition will continue to fight in court for the health and wellbeing of all Americans.”
Congress is unlikely to act while the case remains in the courts.
The White House applauded O’Connor’s ruling, but said the law remains in place while appeals proceed.
Democratic Representative Nancy Pelosi, who is expected to become House speaker in January, vowed to fight what she called an “absurd ruling”.
She said the House “will move swiftly to formally intervene in the appeals process to uphold the life-saving protections for people with pre-existing conditions and reject Republicans’ effort to destroy the Affordable Care Act”.
White House press secretary Sarah Huckabee Sanders said: “We expect this ruling will be appealed to the Supreme Court. Pending the appeal process, the law remains in place.”
Numerous high-ranking Republican politicians said they did not intend to also eliminate popular provisions such as protection for people with pre-existing medical conditions when they repealed the ACA’s fines for people who can afford coverage but remain uninsured.
US Senate Democratic leader Chuck Schumer said: “If this awful ruling is upheld in the higher courts, it will be a disaster for tens of millions of American families.”
Why Is The Law Being Threatened?
Trump promised he would dismantle Obama’s bill during his presidential campaign and find an alternative, yet the ACA continues to operate.
If the case were to reach the Supreme Court it would mark the third time the justices consider a challenge to fundamental provisions of the law.
“Obamacare” opponents lost both the first two cases.
The five justices who upheld the health law in 2012 in the first major case — Chief Justice John Roberts and the court’s four liberals — are all still serving.