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Appeals court rules ACA’s individual mandate unconstitutional; lower court to decide whether rest of law can stand without it Appeals court rules ACA’s individual mandate unconstitutional; lower court to decide whether rest of law can stand without it
(32 minutes later)
A federal appeals court on Wednesday struck down part of the Affordable Care Act, ruling that its requirement that most Americans carry insurance is unconstitutional while sending back to a lower court the question of whether the rest of the law can stand without it.A federal appeals court on Wednesday struck down part of the Affordable Care Act, ruling that its requirement that most Americans carry insurance is unconstitutional while sending back to a lower court the question of whether the rest of the law can stand without it.
The decision by a three-judge panel of the U.S. Court of Appeals for the 5th Circuit has little immediate practical effect because Congress already has removed the penalty for the insurance requirement. But the two-to-one ruling leaves the rest of the sprawling statute in limbo heading into the 2020 presidential and congressional elections in which health-care costs and insurance have emerged as pivotal issues. The decision by a three-judge panel of the U.S. Court of Appeals for the 5th Circuit has little immediate practical effect because Congress already has removed the penalty for the insurance requirement. But the two-to-one ruling leaves the rest of the sprawling statute in limbo heading into the 2020 presidential and congressional elections in which health-care costs and insurance are pivotal issues.
The panel’s one Democratic appointee dissented from the ruling, writing that the Republican states challenging the law did not have standing to do so. If they did, she wrote, she would find the mandate constitutional. The panel’s one Democratic appointee dissented from the ruling, writing that the Republican states challenging the law did not have standing to do so. If they did, she wrote, she would find the mandate constitutional.
The decision carries significant political implications: It catapults to the forefront of the 2020 presidential and congressional campaigns questions about insurance coverage and consumer protections for people with preexisting medical conditions — issues that Democrats wielded in last year’s midterm elections to win a House majority . The 98-page opinion carries significant political implications: It catapults to the forefront of the 2020 presidential and congressional campaigns questions about insurance coverage and consumer protections for people with preexisting medical conditions — issues that Democrats wielded in last year’s midterm elections to win a House majority.
The 5th Circuit decision may or may not be the final word on the ACA, depending on whether its opinion is appealed to the Supreme Court and, if so, whether the high court takes the case. But by sending a thorny legal question back to the Texas jurist who already has held the law unconstitutional, the judges effectively slowed the case, so that the high court could not take it during its current term and decide it before the November elections. The 5th Circuit decision may or may not be the final word on the ACA, depending on whether its opinion is appealed to the Supreme Court and, if so, whether the high court takes the case. But by sending a thorny legal question back to the Texas jurist who already has held the law unconstitutional, the judges effectively slowed the progress of the case, so that the high court cannot take it during its current term and decide it before the November elections.
Wednesday’s ruling resembles the legal position the Trump administration staked out in the case a year ago before the Justice Department hardened its stance to argue in March thatthe whole law is unconstitutional.Wednesday’s ruling resembles the legal position the Trump administration staked out in the case a year ago before the Justice Department hardened its stance to argue in March thatthe whole law is unconstitutional.
The ruling comes in a case initially regarded as marginal by ACA supporters and critics alike. But since last December, when a federal trial court judge held the whole law unconstitutional, it has posed a more serious challenge to the 2010 statute passed by a Democratic Congress and considered a major accomplishment of President Barack Obama’s first term. The ruling comes in a case initially regarded as marginal by ACA supporters and critics alike. But since last December, when a federal trial court judge held the whole law unconstitutional, it has posed a more serious challenge to the 2010 statute passed by a Democratic Congress and considered a major accomplishment of President Obama’s first term.
The lawsuit was filed in February, 2018 by Texas Attorney General Ken Paxton (R) and his counterparts from other Republican-led states — currently 18 in all. Their main argument is that the ACA became unconstitutional when Congress adopted a broad tax bill in late 2017 that, starting this year, eliminated the law’s penalty for people who flout the requirement that most Americans carry health insurance. The plaintiffs pointed out that when the Supreme Court upheld the ACA in 2012, the majority reasoned it was legal under Congress’s taxing powers. The lawsuit was filed in February, 2018 by Texas Attorney General Ken Paxton (R) and his counterparts from other Republican-led states — currently 18 in all. Their main argument is that the ACA became unconstitutional when Congress adopted a broad tax bill in late 2017 that, starting this year, eliminated the law’s penalty for people who flout the requirement that most Americans carry health insurance. The plaintiffs pointed out that when the Supreme Court upheld the ACA in 2012, the majority reasoned it was legal under Congress’s taxing powers.
The two Republican-appointed judges on the 5th Circuit panel sided with this reasoning. Now that Americans are free to ignore the insurance requirement with no risk of penalty, the majority wrote, the “attributes that saved the statute because it could be read as a tax no longer exist.” Those jurists are Judges Kurt Engelhardt appointed by President Trump last year and Jennifer Walker Elrod, an appointee of President George W. Bush. The two Republican-appointed judges on the 5th Circuit panel sided with this reasoning. Now that Americans are free to ignore the insurance requirement with no risk of penalty, the majority wrote, the “attributes that saved the statute because it could be read as a tax no longer exist.” Those jurists are Judges Kurt Engelhardt appointed by President Trump last year and Jennifer Walker Elrod, an appointee of President George W. Bush.
The suit further argues that sections of the law cannot be separated — or severed, in legal parlance — so that if the part of the law that includes the insurance requirement is no longer valid, then the entire law must be considered unconstitutional. The opinion, written by Elrod, also sends parts of the case back to U.S. District Judge Reed O’Connor, a conservative judge on the U.S. District Court for the Northern District of Texas who held almost exactly a year ago that the entire ACA is unconstitutional. The appellate judges direct O’Connor to reconsider the question, known in legal parlance as severability, of whether the mandate can be legally distinct from the rest of the law.
The opinion instructs O’Connor to answer two questions: Which parts of the ACA “are indeed inseverable” now that the mandate is no longer enforced, and whether any ruling in the case should apply onto to the Republican-led states that sued to overturn the law, an issued raised by Trump administration lawyers.
The Republican attorneys general had argued in their lawsuit that sections of the law cannot be separated so that if the part of the law that includes the insurance requirement is no longer valid, the entire law must be considered unconstitutional.
In June of 2018, the Trump administration decided not to defend the law in court. It was an unorthodox step, since the federal government is the defendant in the case, and the executive branch typically defends existing statutes in court.In June of 2018, the Trump administration decided not to defend the law in court. It was an unorthodox step, since the federal government is the defendant in the case, and the executive branch typically defends existing statutes in court.
At first, the Justice Department did not go as far as the GOP attorneys general, contending the insurance requirement and consumer insurance protections should be struck down, while saying the rest of the law could be preserved. However, the administration changed positions early this spring, agreeing with Paxton and the others that the whole law is unconstitutional.At first, the Justice Department did not go as far as the GOP attorneys general, contending the insurance requirement and consumer insurance protections should be struck down, while saying the rest of the law could be preserved. However, the administration changed positions early this spring, agreeing with Paxton and the others that the whole law is unconstitutional.
The law has been defended mainly by a coalition of Democratic attorneys general, led by California’s Xavier Becerra, who contend that, in changing tax law, Congress’s GOP majority lowered the ACA’s tax penalty to zero but did not eliminate it. Even if that aspect of the law were invalidated, Congress gave no hint in the tax law that it intended to disrupt the rest of the ACA, they contend. The law has been defended mainly by a coalition of Democratic attorneys general, led by California’s Xavier Becerra, who contend that in changing tax law, Congress’s GOP majority lowered the ACA’s tax penalty to zero but did not eliminate it. Even if that aspect of the law were invalidated, Congress gave no hint in the tax law that it intended to disrupt the rest of the ACA, they contend.
The opinion follows by five months oral arguments in the case in early July. During the more than 90-minute hearing in a circuit courtroom in downtown New Orleans, the panel’s two Republican appointees, Engelhardt and Elrod, expressed skepticism to varying degrees that the ACA should remain intact.The opinion follows by five months oral arguments in the case in early July. During the more than 90-minute hearing in a circuit courtroom in downtown New Orleans, the panel’s two Republican appointees, Engelhardt and Elrod, expressed skepticism to varying degrees that the ACA should remain intact.
The panel’s lone Democratic appointee, Judge Carolyn Dineen King, a former chief judge of the court who was appointed by President Jimmy Carter, said nothing during the hearing. The panel’s lone Democratic appointee, Judge Carolyn Dineen King, a former chief judge of the court who was appointed by President Jimmy Carter, disagreed with her fellow panel members about both the standing of the GOP attorneys general to bring the case and the mandate’s constitutionality.
The three judges were hearing an appeal of the opinion issued by U.S. District Judge Reed O’Connor issued in mid-December, on the eve of the deadline for the annual sign-up period for Americans to buy health plans through the ACA’s online marketplaces. The 5th Circuit ruling comes weeks before the Nov. 1 start of the enrollment period for 2020 ACA health plans. In her dissent, King wrote that, with Congress having lowered to zero dollars the penalty for people who fail to carry health insurance, “questions about the legality of the individual ‘mandate’ are purely academic, and people can purchase insurance—or not—as they please.”
A Bush appointee, O’Connor is a conservative judge on the U.S. District Court for the Northern District of Texas. As for sending back to the lower court the question of whether the rest of the law remains instact, King wrote: “Answering that question should be easy, since Congress removed the coverage requirement’s only enforcement mechanism but left the rest of the Affordable Care Act in place.” And sending it back to the Texas court “will unnecessarily prolong this litigation and the concomitant uncertainty over the future of the healthcare sector.”
In the 55-page opinion, O’Connor wrote that the law’s individual mandate is unconstitutional because it “can no longer be fairly read as an exercise of Congress’ tax power.” That requirement, he wrote, “is essential to and inseverable from the remainder of the ACA.” If the appellate decision is upheld, the most popular element that would come unglued is insurance protections for Americans with preexisting medical conditions. Congressional Democrats immediatedly seized on that uncertainty. “Trump asked the courts to take away preexisting condition protections for Americans, and after today’s decision, millions of families will go to sleep scared that those protections are still at risk,” Sen. Ron Wyden (Ore.), the Senate Finance Committee’s ranking Democrat, said in a statement.
Despite Trump’s frequent condemnation of the ACA, his administration told the court it was willing to keep the law in place while the case was appealed. O’Connor stayed his decision to let that happen. Republicans cheered the ruling. “I applaud the Fifth Circuit’s decision,” Paxton, the Texas attorney general, said in a statement. “As the court’s opinion recognized, the only reason the Supreme Court upheld Obamacare in 2012 was Congress’ taxing power, and without the individual mandate’s penalty that justification crumbled.”
If the appellate decision is upheld, the most popular element that would come unglued is insurance protections for Americans with preexisting medical conditions. Congressional Democrats immediately seized on that uncertainty. “Trump asked the courts to take away pre-existing condition protections for Americans, and after today’s decision, millions of families will go to sleep scared that those protections are still at risk,” Sen. Ron Wyden (Ore.), the Senate Finance Committee’s ranking Democrat, said in a statement.
Republicans cheered the ruling. “I applaud the Fifth Circuit’s decision,” Paxton, the Texas attorney general, said in a statement. “As the court’s opinion recognized, the only reason the Supreme Court upheld Obamacare in 2012 was Congress’ taxing power, and without the individual mandate’s penalty that justification crumbled.”
Other elements of the law that are at potential risk include insurance subsidies for most people buying health plans through ACA marketplaces, designed for individuals and families that cannot get affordable health benefits through a job; the expansion of Medicaid in three dozen states, the ability of young adults to stay on their parents’ insurance policies until they turn 26; and no-charge preventive care for older Americans on Medicare.Other elements of the law that are at potential risk include insurance subsidies for most people buying health plans through ACA marketplaces, designed for individuals and families that cannot get affordable health benefits through a job; the expansion of Medicaid in three dozen states, the ability of young adults to stay on their parents’ insurance policies until they turn 26; and no-charge preventive care for older Americans on Medicare.
The law also is woven more subtly into many other aspects of the health-care system, from payment formulas for hospitals and doctors, to experiments intended to nudge health-care from a system that pays for the quantity of medical services to one based on the value of care patients receive.The law also is woven more subtly into many other aspects of the health-care system, from payment formulas for hospitals and doctors, to experiments intended to nudge health-care from a system that pays for the quantity of medical services to one based on the value of care patients receive.
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