Another legal battle for Obamacare

MEGAN BASHAM, HOST: Coming up next on The World and Everything in It: another legal battle for Obamacare.

The Affordable Care Act has been a partisan flash point since President Obama signed it into law in 2010. The ACA was one of the most significant legislative victories of his presidency and became known as Obamacare.

MARY REICHARD, HOST: The ACA offers federal subsidies for private health insurance. It also gives financial incentive for states to expand their Medicaid programs. About half the states have done that. And the ACA requires insurance companies to offer coverage to people with pre-existing conditions.

But last month a federal judge in Texas declared the ACA unconstitutional, igniting another debate over the law. WORLD Radio’s Sarah Schweinsberg tells us what’s at stake.

SARAH SCHWEINSBERG, REPORTER: Since the Affordable Care Act was implemented in 2013, millions of Americans have joined the federal program for subsidized healthcare coverage.

In this video posted to social media last month, former president Barack Obama urged people to sign up for 2019 ACA coverage.

OBAMA: So this year, I’m giving it you straight. Sign up for health insurance at Healthcare.gov before the deadline on December 15th.

By the deadline, about 8-and-a-half million Americans had enrolled in 2019 health plans.

But on December 14th, just one day before the enrollment deadline, U.S. District Judge Reed O’Connor ruled the ACA unconstitutional.

Twenty Republican states led by Texas argued that individual mandates requiring people to buy health insurance are unconstitutional—making the entire law unconstitutional. O’Connor agreed.

But in 2012, the Supreme Court ruled individual mandates are constitutional because they are taxes not forced regulatory fines. So how did Judge O’Connor come to the opposite conclusion?

Thomas Miller is a healthcare policy expert at the American Enterprise Institute. He says the 2017 Republican tax reform bill got rid of the individual mandate tax. That means people no longer have to pay a tax penalty if they aren’t insured. Texas and the other states argued that made individual mandates a true regulatory command—not a tax.

MILLER:  They argued that therefore the constitutional underpinnings of the Affordable Care Act as a whole had been eliminated and as a whole was unconstitutional because other parts of the law were not severable from the individual mandate component.

ACA supporters warn that if Judge O’Connor’s ruling stands, it will hurt the 20 million Americans who’ve received insurance through the program. That number includes those who gained coverage through the program’s subsidized private insurance and expanded Medicaid programs.

Here’s Senate Minority Leader Chuck Schumer on the Senate floor four days after the decision.

SCHUMER: If the ruling is ultimately upheld the consequences would be disastrous for the American people….. It would end protections for the 133 million Americans living with preexisting conditions. Can you imagine?

In the weeks following his decision, O’Connor agreed to put it on hold until opponents can appeal.

Because of the ACA’s heavily litigated past, the law’s defenders are confident it will come out of this battle intact as well. California Attorney General Xavier Becerra said in a statement the ACA has already survived more than “70 unsuccessful repeal attempts and withstood scrutiny at the Supreme Court.”

AEI’s Thomas Miller admits the ruling faces a steep uphill legal battle.

MILLER: Now, eight years and more since the law was enacted and more than five years since most of it was implemented… to unravel what’s already been set in place… that is also another deterrent factor in what a court or a higher court, uh, might be willing to do.

On Friday, House Speaker Nancy Pelosi announced the House has asked Judge O’Connor for permission to help defend Obamacare in court.

California and other defendant states will appeal the ruling to the 5th U.S. Circuit Court of Appeals, one of the more conservative circuits.

MILLER: If this lawsuit has a shot anywhere it as a strongest shot in the fifth circuit.

Even though it’s conservative, AEI’s Thomas Miller says the odds of the justices upholding the ruling are still slim because of how entrenched it has become in American life.

MILLER: There’s a low probability chance of probably even getting through the 5th Circuit, let alone the Supreme Court.

Miller predicts the 5th Circuit will issue a decision on whether to uphold the district court ruling before the end of the year.

Reporting for WORLD Radio, I’m Sarah Schweinsberg.

(AP Photo/Patrick Sison) This Oct. 23, 2018 file photo shows HealthCare.gov website on a computer screen in New York. 

WORLD Radio transcripts are created on a rush deadline. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of WORLD Radio programming is the audio record.