Texas judge strikes down Affordable Care Act

A federal judge in Texas has ruled that the Affordable Care Act is unconstitutional, throwing into question coverage for millions of Americans at the deadline for 2019 open enrollment.

Democrats vow to appeal the decision, making it all but certain that the case will be heard by the Supreme Court.

Democratic House leader Nancy Pelosi said the incoming Democratic-led House will intervene in the case.

Ranking Democrats said the decision will be appealed.

"We will take immediate action in the new Congress to intervene in this case and appeal this decision," said Ways & Means Ranking Member Richard Neal of Massachusetts, Energy and Commerce Ranking Member Frank Pallone, Jr. of New Jersey and Education and the Workforce Committee Ranking Member Bobby Scott of Virginia.

"Last month's election results showed how important access to health coverage and protections for pre-existing conditions are for American families, and we are calling for an emergency stay of this heartless ruling," they said.

A coalition of Democratic states, led by California, are reportedly also appealing the decision.

Insurers and providers also decried the decision.

Insurers jumped back into a more stable ACA market this year and premiums came down.

America's Health Insurance Plans President and CEO Matt Eyles said the ruling is just the first step in a lengthy legal process. AHIP will continue to engage as this decision is appealed, he said.

WHAT HAPPENED

U.S. District Court Judge Reed O'Connor said late Friday that the federal law cannot stand without the individual mandate, which ends in January due to the tax bill passed by Congress.

O'Connor said if there is no penalty for not signing up for coverage, then the rest of the law is unconstitutional.

Texas and the 19 other Republican-led states that brought the lawsuit in February.

THE IMPACT

The ruling is not expected to immediately affect Americans' health insurance coverage but throws into question the future of the ACA for insurers providers and the four million who signed up for plans by today's deadline and those covered under Medicaid expansion.

It also strikes down the law's protections for those with preexisting conditions.

Republicans have tried unsuccessfully several times to repeal and replace the law, while keeping protection for those with pre-existing conditions.

REACTION

Trump tweeted, "As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!"

He later added, "Wow, but not surprisingly, ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!"

ON THE RECORD

"We argued in an amicus brief before the court that provisions of the Affordable Care Act affecting patients with pre-existing conditions, and those covered by Medicaid and Medicare should remain law regardless of what the court ruled on the individual mandate," said AHIP President and CEO Matt Eyles. "This decision denies coverage to more than 100 million Americans, including seniors, veterans, children, people with disabilities, hard-working Americans with low-incomes, young adults on their parents' plans until age 26, and millions of Americans with pre-existing conditions. Putting aside this decision, health insurance providers will continue to work hard to ensure the people they serve have confidence that their coverage remains a strong and stable resource to improve their well-being and security."

Dr. Barbara L. McAneny, president of the American Medical Association said, "It will destabilize health insurance coverage by rolling back federal policy to 2009. No one wants to go back to the days of 20 percent of the population uninsured and fewer patient protections, but this decision will move us in that direction."

Dr. Bruce Siegel, president and CEO America's Essential Hospitals said, "Through the Affordable Care Act's marketplace and Medicaid expansion, the nation has made significant gains in reducing the ranks of the uninsured. Those gains have translated to better health and productivity for hard-working people who once could not afford the high cost of coverage. We must not return to a time when the emergency department was their only option for care."

After California Attorney General Xavier Becerra released a statement saying the state would fight the decision, Service Employees International Union in California 1021 President Roxanne Sanchez said, "SEIU members support Attorney General Becerra in vigorously defending Californians' right to healthcare. With the ACA having already withstood right-wing challenges all the way up to the Supreme Court, we are confident this latest Republican attack on healthcare will be overturned.".

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com