The health coverage of 20 million Americans is now at risk, and O'Connor's decision will spur an immediate appeal, as well as the possibility that the 2010 law will once more show up on the docket of the highest court of the land.
Texas Attorney General Ken Paxton, who spearheaded the lawsuit, said the ruling "will give President Trump and Congress the opportunity to replace the failed social experiment with a plan that ensures Texans and all Americans will again have greater choice about what health coverage they need and who will be their doctor".
While congressional Republicans held their silence in reaction to the ruling, Democrats said they would test the GOP's commitment to such popular provisions.
For Democratic Senate Minority Leader Chuck Schumer, the ruling "seems to be based on faulty legal reasoning and hopefully it will be overturned". "Next year, we will force votes to expose their lies".
However, until any appeals process is finished, the act will remain the law of the land, according to White House Press Secretary Sarah Sanders. "This will work its way up through the appeals process".
O'Connor ruled that under the logic of the landmark 2012 Supreme Court ruling that upheld the law, the individual mandate, which required that most Americans obtain health insurance or pay a tax, is now unconstitutional. "Elected and accountable officials at the federal and state level continue to debate how best to ensure the provision of quality health care to the American people". And yet, Republicans have made it clear that their priority is attacking access to critically-needed health care, protections for people with pre-existing conditions, and insurance for young people.More news: SDF Continues to Advance Into Hajin, Last Daesh Stronghold in Syria - Coalition
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If O'Connor's decision stands, about 17 million Americans will lose their health insurance, according to the Urban Institute, a left-leaning think tank. Meanwhile, a number of states are expected to move forward with Medicaid expansion after Democratic victories in the midterm elections.
The Texas case is Texas v. U.S., 4:18-cv-00167-0, U.S. District Court, Northern District of Texas (Fort Worth). "Obamacare" opponents lost both the first two cases. They claimed that when Congress repealed the tax penalty previous year, it eliminated the U.S. Supreme Court's rationale for finding the ACA constitutional in 2012.
Since then public opinion on the ACA has shifted from mostly negative to generally favorable.
Congressional Republicans essentially nulled the individual mandate previous year in their tax reform legislation, setting the financial penalty for failing to acquire health insurance at zero dollars.
In his 55-page opinion, O'Connor writes that the individual mandate is unconstitutional, saying that it "can no longer be fairly read as an exercise of Congress' tax power."The judge also concludes that this insurance requirement "is essential to and inseverable from the remainder of the ACA".
"If this Texas decision on the ACA is upheld, it would throw the individual insurance market and the whole health care system into complete chaos", Larry Levitt, a senior vice-president of the Kaiser Family Foundation, wrote on Twitter. That includes a prohibition on insurers writing policies that exclude a particular condition - for example, a recurrence of breast cancer.