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Texas To Ask Federal Appeals Court To Pull The Plug On Obamacare


The Affordable Care Act is back in court today. Texas v. the United States is hardly the first lawsuit against President Obama's signature law. The Supreme Court has upheld Obamacare in the past. But the plaintiffs in this case have an advantage that others did not. They are basing their case on a way that Obamacare recently changed. Here's NPR's Selena Simmons-Duffin.

SELENA SIMMONS-DUFFIN, BYLINE: Think back to 2017. President Trump had just come into office. Republicans had their chance to kill the Affordable Care Act. They tried for months and months. And by September, it looked like repeal and replace efforts had finally really failed.


PRESIDENT DONALD TRUMP: We are disappointed in certain so-called Republicans.

SIMMONS-DUFFIN: Then just before Christmas, congressional Republicans passed their tax overhaul, announced in the Senate by Vice President Mike Pence.


MIKE PENCE: The Tax Cuts and Jobs Act is passed.

SIMMONS-DUFFIN: That law made the penalty for not having health insurance, part of the ACA's individual mandate, $0. A few months later, Texas led a coalition of 20 states in suing the federal government. Their argument, in 2012, the Supreme Court found the ACA was constitutional because Congress has the power to make a new tax. The penalty for not having insurance, Chief Justice John Roberts wrote, is essentially a new tax. So it is constitutional. Now Texas argued if the penalty is $0, that is not a constitutional tax so the whole law should get tossed. Then this past December, unexpected news.


UNIDENTIFIED REPORTER: The law that brought health care to millions of Americans has been struck down by a U.S. judge.

SIMMONS-DUFFIN: U.S. District Judge Reed O'Connor agreed with Texas and the other plaintiffs that a $0 penalty is not a constitutional tax. Then he wrote, this unconstitutional part can't just be broken off or severed from the rest. The whole law has to go. The next day in the rain, President Trump called it a great ruling.


TRUMP: It was a big, big victory by a highly respected judge.

SIMMONS-DUFFIN: States led by Democrats appealed that decision. That's the hearing happening today. Here are the stakes. The ACA has been law for nine years now. Nearly everything in our health system has been changed by it - who can buy insurance, how you buy insurance, who's covered by Medicaid, whether your employer has to offer insurance and much more. If the law went away, some 20 million people could lose their health coverage.

One weird thing about the case Texas v. United States, United States is no longer on the defending team. A few months ago, the Federal Department of Justice joined with the plaintiffs in arguing the whole ACA is unconstitutional. That leaves on the defending side California, 20 other states and the Democratic-led House of Representatives. Regardless of the decision that comes out of the hearing today, the losing side will almost certainly appeal to the Supreme Court.

Selena Simmons-Duffin, NPR News. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.
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