"Elections have consequences," said Chicago-based healthcare lobbyist Kina Collins, "when we don't put people in who protect the rights of some of the most vulnerable demographics in our country."
"This ruling is likely to affect… 23 million people who get health care coverage under the ACA," Collins said on By Any Means Necessary.
Democratic defeats across the country in 2016, and most notably in the presidential race, will likely mean that decision will likely have "generational impacts," she said, adding that the Supreme Court is more "conservative" in 2018 than it was when it decided on the law's constitutionality in 2012.
US Federal Judge Reed O'Connor ruled that parts of the Affordable Care Act (ACA), a signature piece of healthcare legislation passed under former President Barack Obama, are unconstitutional on December 14.
In his ruling on part of the highly anticipated Texas v. Azar case, O'Connor found a key part of the ACA, the individual mandate, unconstitutional. (Alex Azar is currently the US secretary of health and human services).
Four other parts of the case that haven't been decided in court yet, and the judge has asked the attorneys to meet together by December 21 to decide what to do about those parts and submit a proposed schedule for how to handle them by January 4.
O'Connor held that the individual requirement to buy health insurance, known simply as the individual mandate, was unconstitutional. Supreme Court observers noted that the highest court decided on this case already in 2012, ruling at the time that the individual mandate was constitutional because people who didn't buy health insurance would be taxed for it. Thus, the court found the mandate to be constitutional because Congress has the authority to levy taxes under its interstate commerce authorities.
As part of the Tax Cut and Jobs Act passed under President Donald Trump's administration, the tax on individuals who didn't have health insurance was removed from the federal tax code. This was how O'Connor was able to reach his decision: without a fine in place on people who ditch health insurance, the mandate isn't authorized under Congress' taxation powers, and therefore the law is unconstitutional.
The law's provisions are still in effect in all 50 states and the District of Columbia. O'Connor's decision is likely to be appealed, numerous healthcare experts have said. The appeal would have to take place in the Fifth Circuit Court of Appeals and could wind up being heard by the Supreme Court, Health Affairs noted.
Trump's Justice Department has effectively sabotaged the entire case, with DOJ lawyers not contesting the mandate's unconstitutionality in court. O'Connor wrote in the opinion that DOJ was arguing that "the individual mandate is unconstitutional and inseverable from the ACA's pre-existing-condition provisions." The DOJ argued that the mandate was "inseverable" from other parts of the law — meaning that if the mandate went down as unconstitutional, the rest of the law has to go down with it.
The healthcare law has become one of Washington's go-to political footballs. During Obama's tenure, Congressional Republicans voted more than 60 times to repeal the law in the House, knowing full well their bills stood no chance of becoming law. The Republicans campaigned heavily on "repealing and replacing" the ACA ("Obamacare") in 2016, pointing to massive increases in premiums for health insurance plans as evidence that the law was failing.
Once Republicans maintained majorities in the House and Senate and took control of the White House going into 2017, key members of the party didn't end up wanting to keep some of those campaign promises. In Trump's first major legislative failure, the late Republican Senator John McCain voted to keep the ACA on the books with a famous down-thumbs vote on a repeal measure in July 2017.
