A Federal Judge Has Ruled the Affordable Care Act Unconstitutional: Here's What Happens Now


On December, 14, a Texas judge struck down the Affordable Care Act, or Obamacare, ruling the entire law was unconstitutional based on the mandate that individuals either buy health insurance or face a tax penalty.

Just one day before the open enrollment period for coverage ended, Judge Reed O’Connor claimed the law’s stipulation that individuals maintain coverage or pay a fine could “no longer be sustained as an exercise of Congress’s tax power,” according to The New York Times.

This isn’t the first time the law has been debated in the courts. In 2012, the Supreme Court upheld the ACA, ruling that Congress is allowed to legally tax Americans in order to compel them to buy health insurance. However, since the Trump administration has reduced the penalty to zero dollars, 20 states argued that the fine is no longer constitutional, and Justice O’Connor agreed.

The Times reports that the ruling means millions stand to lose coverage:

If Judge O’Connor’s decision ultimately stands, about 17 million Americans will lose their health insurance, according to the Urban Institute, a left-leaning think tank. That includes millions who gained coverage through the law’s expansion of Medicaid, and millions more who receive subsidized private insurance through the law’s online marketplaces.

The law also protects people with pre-existing conditions, who may see their premiums skyrocket or be denied coverage altogether, and insurance companies could also regain the option to reinstate lifetime caps on coverage. The provision allowing for adults under the age of 26 to stay on their parents’ plans would disappear as well, leaving many young people struggling to find affordable health care.

Predictably, Donald Trump gloated in a Tweet over a decision that might kill millions of Americans:

However, a second message from the White House, sent via e-mail, at least seems to have been written by grown-ups:

The case is “still moving through the courts,” said the message from the federal Centers for Medicare and Medicaid Services. “The marketplaces are still open for business, and we will continue with open enrollment. There will be no impact to enrollees’ current coverage or their coverage in a 2019 plan.”

But though the health coverage many rely on through the ACA isn’t immediately going anywhere as the case moves through the appeals process, no one really knows what this ruling could potentially mean in 2020 and beyond, according to CNN:

“The law is still in effect,” said Tim Jost, emeritus professor, Washington and Lee University School of Law. But, he added of the ruling, “everyone will be confused about what it means.”

Meanwhile, The Washington Post reports that House Minority Leader Nancy Pelosi has already stated House Democrat’s intention to take action:

“When House Democrats take the gavel, the House of Representatives 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.”

According to The New York Times, over half of all Americans are in favor of the ACA, though new enrollment by people who use the the federal website Healthcare.gov is down 20% from last year. This year, 4.1 million Americans have already signed up for 2019 plans.

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