Federal Judge in Texas Rules ACA Unconstitutional, Setting up Extended Legal Battles

Last Friday, Texas Federal District Court Judge Reed O’Connor struck down the Affordable Care Act (ACA) on the grounds that the individual health insurance mandate is unconstitutional and the remaining ACA provisions cannot stand without the individual mandate.

The issue at hand was whether the ACA’s individual mandate still required Americans to obtain health insurance coverage after Congress repealed the financial penalty as part of the tax reform measure signed into law by President Donald Trump in December 2017. In a previous legal challenge to the ACA in 2012, the U.S. Supreme Court upheld the individual mandate as constitutional, determining that Congress could legally impose a tax penalty on people who do not have health insurance. In the latest case out of Texas, however, plaintiffs argued that because Congress zeroed out the tax penalty, the individual mandate was now unconstitutional – and the rest of the ACA could not be severed from the mandate.

Judge O’Connor of Texas agreed with the 18 Republican state attorneys general and two Republican governors who brought the case Texas v. United States. In his Friday ruling, however, Judge O’Connor stopped short of issuing a nationwide injunction, leaving in place the law for the time being.

Citing immense confusion and ambiguity, California Attorney General Xavier Becerra and 15 other states and the District of Columbia filed a motion on Monday to compel the federal judge to clarify that the ACA was still federal law and that consumers are still entitled to ACA benefits and protections. Becerra and others argue that millions of Americans are subject to harm if the ACA is invalidated and the law should be enforced while supporters and opponents of the ACA continue their legal battles. The U.S. Department of Health and Human Services (HHS) released a statement on Monday indicating that because an injunction had not been issued by the federal district court, “HHS will continue administering and enforcing all aspects of the ACA as it had before the court issued its decision.”

The matter will certainly result in continued legal battles and very likely make its way to the Supreme Court once again. Attorney General Becerra and other defendant states indicated on Friday that they would challenge the ruling with an appeal in the U.S. Court of Appeals for the Fifth Circuit in New Orleans. Should the matter continue to the Supreme Court, it will be the third time the court must rule on a constitutional question related to the ACA. Recall, in 2012, the court upheld the law and then rejected to take up another legal challenge in 2015.

While any immediate effect is very unlikely to occur as the result of Friday’s ruling, extended legal battles continue to threaten the survival of the ACA, its coverage of millions of Americans, protections for individuals with pre-existing conditions, and much more.