The ruling, which was issued Friday by Judge Reed O'Connor of the Federal District Court in Fort Worth, holds that the federal mandate requiring the purchase of health insurance is unconstitutional, and that as a outcome, the whole of the Affordable Care Act (ACA) is legally invalid.
The states, which support the health care law, said the ruling on Friday, by Judge Reed O'Connor of the Federal District Court in Fort Worth, had caused huge confusion about whether the law was still in effect, and whether consumers were still entitled to its benefits and protections.
The case is likely to reach the US Supreme Court, where the five justices in the nine-judge court who voted to uphold Obamacare in a separate case in 2012 are still on the bench.
"The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court", he said.
"We have a chance, working with the Democrats, to deliver great HealthCare!"
Thus, the ACA's insurance access and coverage requirements, protection for individuals with preexisting conditions, and provisions addressing the Medicare and Medicaid programs-including those governing Medicaid expansion-remain active and enforceable while the litigation progresses through the appeal process.
Where Roberts might fall this time is anybody's guess - as the case before the lower courts strikes at the heart of his rationale for upholding the law's individual mandate.
Some conservative critics have accused him of providing the roadmap to save ObamaCare, citing a 2011 case where Kavanaugh dissented against the ruling but acknowledged the Affordable Care Act's "individual mandate provision" could fit "comfortably within Congress' Taxing Clause power".
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President Trump is ready to go with the new Congress in January.
That, in part, helps explain why so many Republican candidates claimed to support those protections while campaigning in the 2018 midterms, despite the fact that a group of Republican state attorneys general filed the lawsuit that resulted in Friday's ruling, which threatens to wipe away the ACA's protections if upheld.
The Trump administration declined to defend the constitutionality of the individual mandate but asked the court to delay its decision until after the health insurance exchange open enrollment concluded on December 15, and to defer any holding as to the severability of the individual mandate to the following year.
Supporters of the law immediately said they would appeal. O'Connor only found two individuals had standing to challenge the law, so arguably the ruling only applies to them. "Pending the appeal process, the law remains in place".
In Friday's decision, O'Connor said that because Congress lowered the penalty to zero a year ago, the mandate no longer came with a "tax" and is unconstitutional.
The Texas judge ruled in favor of those arguments. "Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions".
Most legal experts do not believe the Supreme Court would ultimately strike down the entire law, but the uncertainty could pressure stocks in the near term, brokerage Oppenheimer said.