The Fort Worth, Texas-based judge agreed with a coalition of Republican-led states that challenged the law in federal court, after Congress repealed the tax penalty for people who don’t buy insurance. The legitimacy of that fee was part of the Supreme Court’s justification for upholding the law in a previous challenge.
O’Connor’s opinion that the entire ACA can no longer stand would disrupt health-insurance markets and countless other aspects of American health care: expanded Medicaid coverage, rules for employer health plans, and a long list of taxes and changes to Medicare payments, among other policies.
That view is an even more expansive dismissal of the law than the Trump administration’s own position in court. The Justice Department, which typically defends federal laws, asked the court to strike the law’s protections for people with pre-existing conditions along with its mandate that people buy coverage, but leave the rest of the law intact.
Higher Courts
It will be up to higher courts to decide whether any elements of the law should be struck down -- and, if so, how to unwind policies that are now deeply enmeshed in America’s $3.5 trillion health-care system.
“It’s above the judge’s pay grade to invalidate the entire ACA without any possibility of review,” Nicholas Bagley, a law professor at the University of Michigan, wrote on Twitter. Bagley contributed to an brief defending the law in the case.
The ACA has been here before, twice. In the first major legal challenge led by ideological opponents of the law, the Supreme Court in 2012 affirmed that the bulk of the ACA was constitutional, while making Medicaid expansion optional for states. Three years later, the high court left the law intact again.
Five of the current justices on the Supreme Court, including Chief Justice John Roberts, have twice declined to strike down the law. Roberts, now seen as the court’s swing vote, wrote both of those opinions backing the law.
This article was provided by Bloomberg News.