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TX Judge: ACA Unconstitutional         12/15 10:27

   A conservative federal judge in Texas has ruled the Affordable Care Act 
"invalid" on the eve of the sign-up deadline for next year. But with appeals 
certain, even the Trump White House said the law will remain in place for now.

   WASHINGTON (AP) -- A conservative federal judge in Texas has ruled the 
Affordable Care Act "invalid" on the eve of the sign-up deadline for next year. 
But with appeals certain, even the Trump White House said the law will remain 
in place for now.

   In a 55-page opinion, U.S. District Judge Reed O'Connor ruled Friday that 
last year's tax cut bill knocked the constitutional foundation from under 
"Obamacare" by eliminating a penalty for not having coverage. The rest of the 
law cannot be separated from that provision and is therefore invalid, he wrote.

   Supporters of the law immediately said they would appeal. "Today's misguided 
ruling will not deter us: our coalition will continue to fight in court for the 
health and wellbeing of all Americans," said California Attorney General Xavier 
Becerra, who is leading a coalition of states defending the ACA.

   The White House applauded O'Connor's ruling, but said the law remains in 
place while appeals proceed. President Donald Trump tweeted that Congress 
should pass a new law.

   "As I predicted all along, Obamacare has been struck down as an 
UNCONSTITUTIONAL disaster!" Trump tweeted. "Now Congress must pass a STRONG law 
that provides GREAT healthcare and protects pre-existing conditions."

   However, Congress is unlikely to act while the case remains in the courts. 
Numerous high-ranking Republican lawmakers have said they did not intend to 
also strike down popular provisions such as protection for people with 
pre-existing medical conditions when they repealed the ACA's fines for people 
who can afford coverage but remain uninsured.

   Still, Democratic Rep. Nancy Pelosi, who is expected to become House speaker 
in January, vowed to fight what she called an "absurd ruling." She said the 
House "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."

   White House press secretary Sarah Huckabee Sanders said: "We expect this 
ruling will be appealed to the Supreme Court. Pending the appeal process, the 
law remains in place."

   Legal expert Timothy Jost, a supporter of the health law, said O'Connor's 
ruling would have repercussions for nearly all Americans if it stands. If the 
entire health law is invalidated, popular provisions that benefit Medicare 
beneficiaries and people with employer coverage would also be scrapped. That 
could include the section that allows parents to keep young adult children on 
their coverage until age 26.

   About 20 million people have gained health insurance coverage since the ACA 
passed in 2010 without a single Republican vote. Currently, about 10 million 
have subsidized private insurance through the health law's insurance markets, 
while an estimated 12 million low-income people are covered through its 
Medicaid expansion.

   Saturday is the sign-up deadline for 2019 private plans through 
HealthCare.gov. Meanwhile, a number of states are expected to move forward with 
Medicaid expansion after Democratic victories in the midterm elections.

   If the case were to reach the Supreme Court it would mark the third time the 
justices consider a challenge to fundamental provisions of the law. "Obamacare" 
opponents lost both the first two cases.

   The five justices who upheld the health law in 2012 in the first major case 
--- Chief Justice John Roberts and the court's four liberals --- are all still 

   Since then public opinion on the ACA has shifted from mostly negative to 
generally favorable.

   Preserving the law's protections for people with pre-existing medical 
conditions proved to be a strong argument for Democrats in the midterm 
elections. Republicans who tried to undermine those safeguards during their 
failed effort to repeal the health law last year were forced on the defensive 
and went on record saying they, too, want to make sure people with health 
problems can get coverage.

   Democrats set to take control of the House in January are talking about 
passing legislation that enshrines protections for pre-existing conditions. 
It's unclear what form that would take, or if the Republican-majority Senate 
would go along and Trump would sign it.

   The GOP-led states who brought the lawsuit asked O'Connor to toss out the 
entire law after Congress repealed the "individual mandate" penalty for going 
without coverage. The conservative judge had previously ruled against other 
Obama-era policies.

   The Trump administration weighed in, saying the government would no longer 
defend some core components of the ACA, but that others could remain, including 
Medicaid expansion, subsidies for private insurance and health insurance 

   Along with the requirement to have health insurance, the administration said 
the parts of the law that should go included:

   --- The requirement that insurers must take all applicants for comprehensive 
coverage regardless of prior health history, including pre-existing conditions. 
That includes a prohibition on insurers writing policies that exclude a 
particular condition --- for example, a recurrence of breast cancer.

   --- The prohibition on insurers charging higher premiums to people with 
health problems.

   The health insurance industry says doing away with consumer protections will 
destabilize a market that seems to be finding its footing, with modest premium 
increases and more plan choices next year.

   The American Medical Association called O'Connor's ruling an "unfortunate 
step backward for our health system that is contrary to overwhelming public 
sentiment to preserve pre-existing condition protections."


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