Somewhere along the process, O'Connor's ruling on severability will get a very skeptical reading by the higher courts.
U.S. District Judge Reed O'Connor in Fort Worth issued the ruling late Friday, on the eve of the final day of open enrollment for ACA coverage. The rest of the law can not be separated from that provision and is therefore invalid, he wrote. The law remains in place for the foreseeable future, but it certainly stands on shakier ground today than it did just a few days ago.
"During a year when most people don't know when the deadline is, if the only news you hear is that the ACA was struck down, that is only going to hurt enrollment", Josh Peck, co-founder of Get America Covered and former chief marketing officer for Healthcare.gov during the Obama administration, said in an email. "While we are disappointed in the recent Northern District of Texas court's ACA ruling, we recognize that this is a first step in what will be a lengthy appeals process", the company said in a Monday statement. He tweeted Friday night that "As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster!"
If the court were to overturn the law, it would leave the Trump administration and a divided Congress in a remarkably hard situation - scrambling to come up with an alternative that has eluded the law's critics in Washington ever since its passage in 2010.
On the defensive, Republicans campaigning this fall promised that they, too, backed the health law's protections for people with pre-existing medical conditions.
U.S. House Speaker Nancy Pelosi condemned the ruling and promised that the House of Representatives would participate in appeals after control of the legislative body passed to the Democrats in 2019.
"A lot of good people are fighting to ensure that nothing about your care will change".
Stephen Miller: Trump 'absolutely' willing to shut down government over border wall
Trump, during his 2016 presidential campaign, promised that Mexico would pay for the wall. Postal Service would still operate, and mail would be delivered as usual.
The White House said it expects the ruling to be appealed to the Supreme Court.
Supporters of the law immediately said they would appeal. The Democrats are arguing that it was never the intent of the lawmakers who wrote the 2017 tax law to repeal the ACA. "Such as coverage of people with pre-existing conditions, the mandated benefits for substance abuse and mental illness treatment, and also allowing young people to stay on their parents' policies until age 26".
If millions were to lose insurance coverage at once, the costs for all consumers could skyrocket, says Kaiser health care analyst Larry Leavitt.
Since the law's formative stages amid concern about millions of Americans lacking health insurance, Republicans have opposed Obamacare, calling it a costly and unneeded government intrusion into Americans' lives.
Henneke added states should prioritize "market-based solutions but also regulations that will provide for choice".
If the case were to reach the Supreme Court it would mark the third time the justices consider a challenge to fundamental provisions of the law.
Healthcare, as a federal entitlement, has deeply divided the two major political parties, especially since Obamacare was first enacted in 2010. The plaintiffs argued that because the Supreme Court upheld the ACA in 2012 as a constitutional use of its taxing power, the elimination of the tax makes the rest of the law unconstitutional.
Since then public opinion on the ACA has shifted from mostly negative to generally favorable. In fact, Republicans just spent a majority of the 2018 midterm election cycle affirming their support for protections for pre-existing conditions. The US Supreme Court twice upheld it, emphasizing that history, and the law survived countless attempts by Republicans to repeal it. House Democrats are expected to introduce a resolution defending the law immediately after the 116th Congress is sworn in on January 3.