The future of the United States's Affordable Care Act (ACA), also known as Obamacare, could be at stake on Tuesday when a group of Democratic-led states and the House of Representatives urge a federal appeals court to overturn a Texas judge's ruling that the U.S. healthcare reform law is unconstitutional.
Among the arguments by the law's supporters: Those who filed suit have no case because they aren't harmed by a penalty that doesn't exist; the reduction of the tax penalty to zero could be read as a suspension of the tax, but the tax's legal structure still exists; and even if the individual mandate is now unconstitutional, that does not affect the rest of the law known as the Affordable Care Act.
Justice Department attorney August Flentje, facing questions about the administration's approach, said the government would enforce it until a final decision comes. Elrod peppered both sides with questions. And she appeared highly focused on her court's options for ordering a remedy, seeming to weigh options for sending the case back to a lower court for further consideration. One of the first acts of our new Majority in January was to allow the House to defend the Affordable Care Act in this case, and House Democrats have passed additional legislation to protect and expand coverage and take steps to lower prescription drug costs.
The Senate, Engelhardt remarked, "is sort of the 800-pound gorilla that's not in the room".
It was unclear when the panel would rule.
Whatever happens, the case is likely to end up before the Supreme Court sometime next year - dropping a politically radioactive issue into the middle of a heated presidential campaign. Either court could decline to hear the case.
A judge in Fort Worth, Texas, concluded in December that wiping out the penalty undermined the ACA's constitutional basis and invalidated the whole law. The House of Representatives intervened on appeal. Engelhardt demanded. "Isn't that exactly the point?"
"The morning I woke up when the Affordable Care Act was enacted, I started sobbing, because from that second on I never had to worry about losing health insurance because of my pre-existing condition", Nathan said.
Samuel Siegel, California's deputy solicitor general, argued that Congress intentionally eliminated only the penalty for not having coverage and that Congress specifically meant for the rest of the law to stay on the books.
But the court may still go another way. Elrod asked several questions about which provisions were more directly connected to the individual mandate.
The Heritage Foundation's Marie Fishpaw on efforts to reform America's health-care system. But if the Texas-led coalition succeeds this time, it could bring unintended consequences for the GOP-led states.
In 2018, Democrats mainly relied on messaging that touted the Affordable Care Act and its coverage of pre-existing conditions. "Republicans should be the party of healthcare and we should come together on a workable proposal to replace Obamacare".
"Today, House and Senate Democrats are here to show the human stakes of the GOP's relentless assault on health care", Pelosi said.
O'Connor, nominated by former Republican President George W Bush, said that because Obamacare called the mandate "essential", the entire law must be struck down. "Most people in this state don't even know this lawsuit is underway, quite frankly". By 2026, the increase is expected to climb to 50 percent following the elimination of the Medicaid expansion. Experts expect it to climb significantly if Obamacare is repealed.
Legal scholars, including many on the right, have always been dubious about Texas' arguments, particularly on the question of severability. Many did not take the lawsuit very seriously until December, when U.S. District Judge Reed O'Connor sided with Texas and struck down the law.
Texas Solicitor General Kyle Hawkins warned the judges that "congressional intent is not monolithic, and it's a very hard and unsafe game" to try to second-guess what Congress really meant.
"If they have their way, millions of Americans could be forced to delay, skip or forego potentially life-saving healthcare", California Attorney General Xavier Becerra said in a statement. "Our state coalition made it clear: on top of risking lives, gutting the law would sow chaos in our entire healthcare system".