On Friday night, a Fort Worth judge struck down President Obama's signature health care law — the Affordable Care Act — ruling it unconstitutional. This isn't the first time the Affordable Care Act has been in court. In 2012, the Obamacare Supreme Court ruling upheld the health care law. If this new appeal makes it to the Supreme Court it could happen again — or the Affordable Care Act could be done.
In December 2017, President Trump's tax overhaul bill eliminated the individual mandate of the Affordable Care Act, which required citizens to buy health care or pay a penalty. This is what the new lawsuit, filed by 20 states earlier in 2018, zeroes in on: the elimination of the individual mandate. According to The New York Times, Obamacare's individual mandate was upheld in 2012 "based on Congress's taxing power" because Congress can levy taxes on those of us who don't have health insurance. The 20 states (led by Texas) contended that with the individual mandate eliminated by the tax reform in 2017, the law can't stand on it own.
Federal Judge Reed O'Connor wrote in the Friday decision that the individual mandate "can no longer be sustained as an exercise of Congress’s tax power." You can read the judge's decision from Friday in full here.
The defendant states plan to appeal the decision at the U.S. Court of Appeals for the Fifth Circuit in New Orleans. "Today's ruling is an assault on 133 million Americans with pre-existing conditions, on the 20 million Americans who rely on the A.C.A.'s consumer protections for health care, on America’s faithful progress toward affordable health care for all Americans," California Attorney General Xavier Becerra said in a statement to the New York Times. California is one of the states defending the law. "The A.C.A. has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court."
Potentially on the side of the defendants is that in June 2012, the Affordable Care Act — and the individual mandates — was upheld with Chief Justice John Roberts writing the court's opinion. The court found that individual mandate penalties for those who didn't purchase insurance coverage were a tax. "The payment is not so high that there is really no choice but to buy health insurance; the payment is not limited to willful violations, as penalties for unlawful acts often are; and the payment is collected solely by the (Internal Revenue Service) through the normal means of taxation," Roberts wrote in the decision.
No matter which side prevails at the Fifth Circuit, it's likely the law will be appealed to the Supreme Court, putting it back in front of Roberts — and two new conservative justices.
While numerous experts have cast their doubts on the potential efficacy of the challenge's arguments, Vox's Sarah Kliff (one of the nation's top health care reporters) pointed out that previous challenges to Obamacare — like King v. Burwell — that were written off at first went on to become important court decisions. One scholar told Kliff that these kind of lawsuits could encourage states to undertake even more challenges to Obamacare. "I worry about this shadow hanging over the law, the way that other challenges have. We've all lived through this before," Georgetown professor Katie Keith told Vox. "This gives states another reason to act to thwart the law."