The Affordable Care Act (ACA) is facing one of its biggest challenges to date as arguments began Wednesday, Sept. 5, in a live-or-die lawsuit that could potentially nullify the healthcare law.
The suit, which was launched by 20 Republican state attorneys general and GOP governors at the beginning of 2018, argues that the law is no longer constitutional since the individual mandate was stripped out in the most recent spending bill. The Supreme Court previously ruled that the ACA was valid based on the notion that the individual mandate could be treated like a tax.
The arguments scheduled to start Wednesday will be led by Texas Attorney General Ken Paxton. GOP plaintiffs are also seeking an injunction while the case is ongoing.
“The U.S. Supreme Court already admitted that an individual mandate without a tax penalty is unconstitutional,” Paxton said in a statement at the time of the filing. “With no remaining legitimate basis for the law, it is time that Americans are finally free from the stranglehold of Obamacare, once and for all.”
Since its passage in 2010, the ACA has extended several benefits to Americans, including protections for those with pre-existing conditions, allowing young adults to stay on their parents’ insurances until they are 26, and no copays for preventive care. Furthermore, its impact on the shift toward value-based care has been even more far-reaching into the current market, significantly impacting mergers and acquisitions as providers and payers move to succeed in a world increasingly focused on value-based care.
The Department of Justice, usually tasked with defending laws, does not stand behind the ACA when it comes to the lawsuit. Instead, the agency has more or less sided with the plaintiffs in the case on the argument that the tax construction of the ACA is no longer available, the DOJ stated in a legal filing. However, the DOJ also argued an injunction of immediate relief of the law is not warranted since the mandate will not become unconstitutional until 2019.
In addition, the Trump administration has attempted to dismantle the ACA, despite a lack of action from Congress on its core provisions, and implementing new policies that undermine the integrity of the healthcare law. For example, within the last year the administration expanded temporary, short-term health plans that are not required to meet Obamacare standards, flip-flopped on its position to pay out billions of dollars in risk-adjustment payments to insurance providers and stabilize ACA marketplaces, and stifled enrollment. These actions have led to a lawsuit against the administration by a few major cities arguing it is unlawful for the President and officials to actively sabotage the law.
The case is being presided over by Judge Reed O’Connor of the Federal District Court for the Northern District of Texas. Should the court find the law unconstitutional and strike down the ACA, millions of Americans will likely lose their insurance, while millions more will lose certain benefits. The Judge could also side with the DOJ and strike down only the individual mandate and protections for pre-existing conditions, according to The New York Times.