A federal judge in Texas has ruled that the Affordable Care Act (ACA), otherwise known as Obamacare, is unconstitutional.
ACA Background
The Patient Protection and Affordable Care Act (ACA) came into effect in 2014, stopping the industry practice of denying coverage due to pre-existing conditions and requiring that all Americans maintain minimum health insurance. Failure to maintain that minimum coverage resulted in a penalty.
The constitutionality of the minimum insurance requirement was upheld by the United States Supreme Court under Congress’ taxation power in National Federation of Independent Business (NFIB) v. Sebelius.
However, the December 2017 Tax Cuts and Jobs Act (TCJA) amended the ACA by eliminating the penalty for not maintaining minimum health insurance.
Texas v. Azar
Twenty states filed suit against the United States, the Department of Health and Human Services, Secretary of Health and Human Services Alex Azar, the Internal Revenue Service, and David Kautter, Commissioner of Internal Revenue, arguing that the revised ACA was unconstitutional. Essentially, the states argued that the elimination of the health care requirement meant that there was no longer a tax, and no longer constitutional.
The Justice Department filed a brief saying that it would not defend the ACA, so a group of 16 Democratic-led states and the District of Columbia intervened to defend the ACA. A coalition of physician groups filed an amici curiae brief to support the ACA. The participating groups included the American Medical Association (AMA), the American Academy of Family Physicians, the American College of Physicians, the American Academy of Pediatrics (AAP), and the American Academy of Child and Adolescent Psychiatry.
Read OTW’s prior coverage of the case here: “Texas Lawsuit Challenges ACA”(https://ryortho.com/2018/09/texas-lawsuit-challenges-aca/) and “Maryland Sues to Head Off Texas ACA Challenge”.
In a 55-page opinion, Judge Reed O’Connor ruled that the ACA is unconstitutional. He wrote, “The court finds the individual mandate can no longer be fairly read as an exercise of Congress’s tax power and is still impermissible under the interstate commerce clause―meaning the individual mandate is unconstitutional…. [T]he court finds the individual mandate is essential to and inseverable from the remainder of the ACA.”
