WASHINGTON • A federal judge in Texas threw a dagger into the Affordable Care Act (ACA), ruling that the entire healthcare law is unconstitutional because of a recent change in federal tax law.
The opinion by US District Judge Reed O'Connor last Friday overturns all of the sprawling law nationwide.
The ruling came on the eve of the deadline yesterday for Americans to sign up for coverage in the federal insurance exchange created under the law.
If the ruling stands, it would create widespread disruption across the US healthcare system - from no-charge preventive services for older Americans on Medicare to the expansion of Medicaid in most states - in all, hundreds of provisions in the law that was a prized domestic achievement of former president Barack Obama.
President Donald Trump, who has made the dismantling of the ACA a chief goal since his campaign, swiftly tweeted his pleasure at the opinion.
"As I predicted all along, Obama-care has been struck down as an UNCONSTITUTIONAL disaster!" he wrote. "Now Congress must pass a STRONG law that provides GREAT health care and protects pre-existing conditions."
Later, the White House issued a statement on the ruling, saying: "We expect this ruling will be appealed to the Supreme Court. Pending the appeal process, the law remains in place."
For their part, congressional Democrats, who defended the law and its protections for people with pre-existing medical problems as a major theme leading up to last month's midterm elections, lambasted the Texas judge and portrayed themselves as champions of American healthcare consumers.
House Minority Leader Nancy Pelosi, who is expected to become Speaker next month, issued a statement that said: "When House Democrats take the gavel, the House of Representatives will move swiftly to formally intervene in the appeals process to uphold the life-saving protections for people with pre-existing conditions and reject Republicans' effort to destroy the Affordable Care Act."
Major segments of the healthcare industry decried the ruling. "The judge got it wrong," said Mr Charles Kahn III, president of the Federation of American Hospitals. "This ruling would have a devastating impact on the patients and the nation's healthcare system as a whole... Having this decision come in the closing hours of open enrolment also sows seeds of unnecessary confusion."
No matter how Judge O'Connor ruled, legal experts have been forecasting that the Texas case would be appealed and could well place the law again before the High Court, giving its conservative newest member, Justice Brett Kavanaugh, a first opportunity to take part.
The lawsuit was initiated by Texas Attorney-General Ken Paxton. The plaintiffs argue that the entire ACA is invalid. They trace their argument to the Supreme Court's 2012 ruling, in which Chief Justice John Roberts Jr wrote that the penalty the law created for Americans who do not carry health insurance is constitutional because Congress "does have the power to impose a tax on those without health insurance".
As part of a tax overhaul a year ago, congressional Republicans pushed through a change in which that ACA penalty will be eliminated, starting in January. The lawsuit argues that, with the enforcement of the insurance requirement gone, there is no longer a tax, so the law is no longer constitutional.
"Once the heart of the ACA - the individual mandate - is declared unconstitutional, the remainder of the ACA must also fall," the lawsuit said.
Mr Trump has vowed to dismantle the law, a main domestic achievement of Mr Obama, and the administration has been taking steps to foster alternative insurance that tends to be less expensive because it skirts ACA requirements.
WASHINGTON POST
