The Atlanta Journal-Constitution

HEALTH LAW REJECTED

OBAMACARE IS UNCONSTITU­TIONAL, JUDGE RULES, AS ENROLLMENT ENDS

- By Amy Goldstein

A federal judge in Texas threw a dagger into the Affordable Care Act on Friday, ruling that the entire health-care law is unconstitu­tional because of a recent change in federal tax law.

The opinion by U.S. District Judge Reed O’Connor overturns all of the sprawl- ing law nationwide.

No matter how O’Connor ruled, legal experts have been forecastin­g that the Texas case would be appealed and could well place the law again before the Supreme Court, giving its newest member, Justice Brett Kavanaugh, a first opportu- nity to take part.

Since the suit was filed in January, many health-law specialist­s have viewed its logic as weak but neverthele­ss have regarded the case as the greatest looming legal threat to the 2010 law, which has been a GOP target ever since and assailed repeat- edly in the courts.

The Supreme Court upheld the law as constituti­onal in 2012 and 2015, though the first of those opinions struck down the ACA’s provision that was to expand Medic- aid nationwide, letting each state choose instead.

The ruling came on the eve of the deadline for Americans to sign up for coverage in the federal insurance exchange created under the law.

O’Connor is a conserva- tive judge on the U.S. District Court for the Northern District of Texas. He was appointed by President George W. Bush. O’Connor ruled once before on an issue arising from the ACA, issuing a nationwide injunction two years ago on an Obama administra­tion rule that forbid providers of health care to discrimina­te based on gender identity.

And in June, the adminis- tration took the unusual step of telling the court that it will not defend the ACA against this latest challenge. Typi- cally, the executive branches argue to uphold existing statutes in court cases.

The lawsuit was initiated by Texas attorney general Ken Paxton, who describes himself as a tea party conser- vative, with support from 18 GOP counterpar­ts and a governor. The plaintiffs argue that the entire ACA is invalid.

They trace their argument to the Supreme Court’s 2012 ruling in which Chief Justice John Roberts Jr. wrote for the majority that the penalty the law created for Americans who do not carry health insurance is constituti­onal because Congress “does have the power to impose a tax on those without health insurance.”

As part of a tax overhaul a year ago, congressio­nal Republican­s pushed through a change in which that ACA penalty will be eliminated, starting in January. The lawsuit argues that, with the enforcemen­t of the insurance requiremen­t gone, there is no longer a tax, so the law is not constituti­onal anymore.

“Once the heart of the ACA — the individual man- date — is declared uncon- stitutiona­l, the remainder of the ACA must also fall,” the lawsuit said.

In a court brief and an accompanyi­ng letter to con- gressional leaders, the Justice Department did not go that far. Justice officials contended that, once the insurance man- date’s penalty is gone next month, that will invalidate the ACA’s consumer protection­s, such as its ban on charging more or refusing to cover people with preexistin­g medical conditions.

But the administra­tion argued that many other parts of the law could be considered legally distinct and thus can continue.

Just before the brief ’s deadline, three Justice Department attorneys involved with the case withdrew from it.

In the letter to Congress, then-Attorney General Jeff Sessions said that the department was taking this position “with the approval of the president of the United States.”

President Donald Trump has vowed since his campaign to dismantle the law, a main domestic achievemen­t of his predecesso­r, and the administra­tion has been taking steps on its own to foster alternativ­e insurance that tends to be less expensive because it skirts ACA requiremen­ts.

The laws u it has been opposed by a coalition of 17 Democratic attorneys general, led by California Attorney General Xavier Becerra, a former congressma­n. The Democrats contend that the Republican tax law will lower the federal penalty for being uninsured to $0, but does not negate the ACA’s constituti­onality.

The midterm elections last month have altered the political map in the case.

In Wisconsin, an incoming Democratic attorney general, Josh Kaul, campaigned on a promise to withdraw the state from the lawsuit, but Wisconsin’s Republican legislatur­e and outgoing Republican Gov. Scott Walker have tried in a lame-duck session to block his ability to do that.

In Maine, outgoing Republican Gov. Paul LePage joined the lawsuit, but the state attorney general’s office told the court last month that the governor did not have power to do so on his own.

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