While the eyes of the nation were on the historic House vote to impeach President Donald Trump, a court ruling to leave the fate of Obamacare up in the air may be a bigger risk to his 2020 re-election hopes.

The ruling Wednesday in a lawsuit led by Republican states and backed by Trump rendered Obamacare’s individual mandate to buy insurance unconstitutional, but punted on whether that meant the rest of the law must also be invalidated. That issue was sent back to the lower court judge to determine, which all but ensures the issue won’t be resolved by the election.

Democrats vying for their party’s presidential nomination have made health care a central issue, debating over how far-reaching government involvement should be. But the ruling highlights the one issue they are united on -- that the Affordable Care Act’s protections should not be undone.

“We knew that health care was going to be a 2020 political issue. This guarantees that there will be a really vigorous debate about how you cover people,” said Douglas Holtz-Eakin, the president of the American Action Network, a conservative research and advocacy group.

The issue has played “really badly” for Republicans, he said, which is one reason party strategists were hoping that the court of appeals in New Orleans would uphold the rest of the law so they could move on.

A decision to eliminate Obamacare would have forced cataclysmic changes in the health-care system, wiping away billions of dollars in assistance and consumer protections.

Republicans lost a wave of House races and governor’s mansions in 2018 because of a backlash against their failed attempts to roll back the ACA. Exit polls published by CNN found that health care was the primary issue for 2018 voters, and those who selected it preferred Democratic candidates by 75% to 23%. Republicans “disqualified themselves with the public on health care,” Holtz-Eakin said.

After Wednesday’s ruling, Democratic lawmakers condemned it. Speaker Nancy Pelosi issued a statement during the impeachment debate calling the decision a “chilling threat to the 130 million Americans with pre-existing conditions and every other family who depends on the lifesaving protections of the Affordable Care Act.

“Despite their claims to support protections for people with pre-existing conditions, Republicans have taken every opportunity to dismantle them,” she said.

‘Laid a Time Bomb’

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