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 U.S. District Judge Reed O'Connor in Fort Worth, Texas, on Friday
said that Obamacare, known formally as the 2010 Affordable Care Act
(ACA), was unconstitutional based on its mandate requiring that
people buy health insurance.
In a decision that could reach the U.S. Supreme Court, O'Connor
sided with a coalition of 20 states that argued requiring people to
pay for insurance coverage is illegal because a change in tax law
last year eliminated a penalty for not having health insurance.
"It's a great ruling for our country. We will be able to get great
healthcare. We will sit down with the Democrats if the Supreme Court
upholds," Trump told reporters during a visit to Arlington National
Cemetery in Virginia on a rainy Saturday.
Trump offered no details on the potential for healthcare talks with
the Democrats, who are poised to take majority control of the U.S.
House of Representatives in early January. The Senate will remain in
Republican hands.
O'Connor's decision was issued the day before the end of a 45-day
sign-up period for 2019 health coverage under the law.
The head of the federal Centers for Medicare and Medicaid Services
(CMS), which oversees the Affordable Care Act, said there were no
changes and exchanges were open for business.
"We expect this ruling will be appealed to the Supreme Court," CMS
Administrator Seema Verma wrote on Twitter on Saturday. "Pending the
appeal process, the law remains in place.”
"There is no impact to current coverage or coverage in a 2019 plan,”
she said late on Friday.
HIGH POLITICAL STAKES
Since the law's formative stages amid concern about millions of
Americans lacking health insurance, Republicans have opposed
Obamacare, calling it a costly and unneeded government intrusion
into Americans' lives. Trump campaigned against it in 2016.
They have repeatedly tried, but failed, to repeal the law, which was
the signature domestic policy achievement of former Democratic
President Barack Obama. Even with control of both chambers of
Congress and the White House in 2017, Republicans could not push
through a repeal.
The O'Connor ruling underscored the high political stakes involved
in the divide over healthcare, especially for Trump and his fellow
Republicans ahead of the 2020 presidential election.
If the Supreme Court were to uphold O'Connor's ruling, it would go a
long way toward dismantling Obamacare. That would be a political
victory for Republicans, but it would also likely strip millions of
Americans of their health coverage, a policy problem for which
Republicans have offered no clear solution.
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About 11.8 million consumers nationwide enrolled in 2018 Obamacare
exchange plans.
The Supreme Court upheld the Affordable Care Act in 2012.
Two days after the Nov. 6 U.S. congressional elections, a Reuters/Ipsos
national opinion poll found that healthcare was the top issue
Americans wanted the U.S. Congress to address.
'SILLY, IRRESPONSIBLE'
On Friday, O'Connor ruled that after the enactment last year by
Trump of a landmark tax bill, the ACA's individual mandate requiring
most Americans to obtain health insurance or pay a tax could no
longer be considered constitutional.
He said because the individual mandate was an "essential" part of
Obamacare, the entire law, rather than just the individual mandate,
was unconstitutional.
Timothy Jost, a health law expert and emeritus professor at
Washington and Lee University School of Law in Virginia, said it was
“silly” and “irresponsible” for O’Connor to find that the individual
mandate could not be separated from the rest of the ACA. He said
judges who find that portions of laws are invalid are required “to
do as little damage as possible” to the rest of the law, and
O’Connor had ignored that principle.
Jost noted that the 5th U.S. Circuit Court of Appeals, which will
hear any appeal in the case, is considered the most conservative
federal appeals court in the country. But, “O’Connor is so far off
the reservation here that virtually any (appeals) panel will reverse
him,” Jost said.
Jost noted that in the 2012 case in which the Supreme Court upheld
the ACA, a lower appeals court had found the individual mandate
unlawful, but ruled it could be severed from the rest of the law.
That ruling by the 11th U.S. Circuit Court of Appeals “is at least
as persuasive and probably more persuasive than a decision by a
single judge in Wichita Falls, Texas,” Jost said.
He said the U.S. Supreme Court’s conservative wing has been
skeptical in the past of striking down entire laws because of a
single problematic provision, and at least a bare majority of five
justices would likely agree that O’Connor was wrong.
(Reporting by Caroline Stauffer, Dan Wiessner, Lesley Wroughton,
Katanga Johnson, and Kevin Drawbaugh in Washington; additional
reporting by Daniel Wiessner in Albany, New York; Editing by Steve
Orlofsky and Jonathan Oatis)
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