How Will The Obamacare Ruling Affect Americans Covered Under The ACA?

A Texas federal Judge ruled on Friday that the entire Affordable Care Act (ACA), or Obamacare, was rendered unconstitutional after Congress eliminated the individual mandate - a federal requirement to buy insurance or face a penalty.

At issue in the case was the individual mandate, which requires people to have health insurance. The penalty for not having insurance was dropped to $0 in the most recent tax legislation, potentially undercutting the Supreme Court's decision in 2012 that the Affordable Care Act was constitutional because of Congress' ability to tax. 

With no penalty, there's no tax, the plaintiffs, a coalition of Republican-led states, argued in the Texas case. The plaintiffs also argued that the individual mandate is so essential to the entire law, so that if it's unconstitutional, the rest of the law must also be thrown out. U.S. District Court Judge Reed O'Connor agreed on that point, too. -CBS News

The ruling came just one day before the december 15 deadline to sign up for health coverage in 2019 through the ACA's marketplace. 

How will this the ruling affect people covered under the ACA? It won't, for now - and people can still sign up for coverage through Saturday. "Court's decision does not affect this season's open enrollment," reads a notice on HealthCare.gov. 

The Trump White House has said that the existing law will stand for now while the ruling works its way through the appeals process up to the Supreme Court - a process which could take years. Some, such as Vox's Ezra Klein, have suggested that since Congress removed the individual mandate with the intention of keeping Obamacare intact, the Texas ruling is judicial overreach and the ruling is unlikely to stand.

"We expect this ruling will be appealed to the Supreme Court. Pending the appeal process, the law remains in place," said White House Press Secretary Sarah Sanders in a statement, adding that Trump is now calling on Congress to replace the Affordable Care Act. 

That didn't stop Trump from throwing salt in the wound - tweeting on Saturday: "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!"

That said, if the law is ultimately invalidated, other well-liked sections of the law are likely to be scrapped according to CBS Newssuch as the provision allowing adult children to remain on their parents insurance coverage until age 26 - whether or not they live in the basement. 

Moreover, invalidating the ACA would eliminate the mandate that insurance companies cannot discriminate against pre-existing conditions, as well as the ban on annual lifetime limits for coverage. 

Democrats immediately jumped on the Friday night ruling to warn that health care coverage for millions of Americans was at stake due to the Republican-led lawsuit that sought to void popular parts of Obamacare, including protections for pre-existing conditions and a ban on annual lifetime limits. -Bloomberg

House Speaker-in-waiting Nancy Pelosi said that the ruling "exposes the monstrous endgame of Republicans’ all-out assault on people with pre-existing conditions and Americans’ access to affordable health care."

Trump, of course, celebrated - though not everyone agrees... "When Trump says this is ‘great for America,’ he’s forgetting the health care driven whipping Republicans got in the midterms," said Andy Slavitt - the man who oversaw the implementation of the ACA for the Obama administration, who added "Rather than let that heal, he’s making health care a 2020 prime fight and also putting Republicans in the Senate at great exposure."

Republicans struggled with the issue in the campaign. They vowed to support protections for Americans with pre-existing conditions, even if they backed the lawsuit or legislation that would undo those provisions. One prominent Republican ally of Trump said health care could be his “Achilles heel” in 2020, when he’s up for re-election. -Bloomberg

"I’m not sure Republicans even know what they’re fighting for right now when it comes to health care," said former GOP Congressman from Florida who is now an independent. "Opposing Obamacare has become reflexive GOP orthodoxy, but they just spent six months saying they’d protect pre-existing conditions. Hard to square GOP campaign promises with the court victory by GOP attorneys general," he added. 

The next step for the matter will be the Fifth Circuit Court of Appeals - the most conservative appellate court in the country, according to Bloomberg. If they uphold the decision, it's likely headed to the Supreme Court. On the other hand if the Fifth Circuit reverses the decision, the Supreme Court likely won't hear the case, according to legal experts. 

I can’t see who in the Fifth Circuit swallows this, and if they don’t,” the Supreme Court won’t take the the case, predicted Adler, who’s also a member of the conservative Federalist Society.

Nicholas Bagley, a professor at University of Michigan Law School, said he doubts the case will make it to the Supreme Court. By far the likeliest outcome is that it gets rejected on appeal at the Fifth Circuit, he said in an email, adding, “No serious conservative has yet endorsed this litigation. That includes very hard-line conservatives.” -Bloomberg

Republican Kevin Brady - the House Ways and Means Committee Chairman who assisted in the unsuccessful Republican bill to repeal Obamacare in 2017, said that the ruling was "not surprising," as the law was "embarrassingly designed. 

If Friday's ruling is upheld, Brady says "ultimately both parties should start over.