Affordable Care Act

Jackie Fortier / StateImpact Oklahoma

At the beginning of November, hundreds of new laws took effect in Oklahoma, including a big change to short-term health policies. 

The very day President Trump was sworn in — Jan. 20, 2017 — he signed an executive order instructing administration officials "to waive, defer, grant exemptions from, or delay" implementing parts of the Affordable Care Act, while Congress got ready to repeal and replace President Obama's signature health law.

A decision in the latest court case to threaten the future of the Affordable Care Act could come as soon as this month. The ruling will come from the panel of judges in the 5th Circuit Court of Appeals, which heard oral arguments in the Texas v. Azar lawsuit.

An estimated 24 million people get their health coverage through programs created under the law, which has faced countless court challenges since it passed.

The fate of the Affordable Care Act is again on the line Tuesday, as a federal appeals court in New Orleans takes up a case in which a lower court judge has already ruled the massive health law unconstitutional.

President Trump, bowing to political reality, says he is putting off his thoughts of finding a replacement for the Affordable Care Act until after the 2020 election.

In remarks to reporters Tuesday, Trump said, "I wanted to put it after the election because we don't have the House." But it became clear that he didn't have support for a replacement to Obamacare in the GOP-led Senate, either.

Updated at 1:40 p.m. ET

The assertion by Attorney General William Barr that special counsel Robert Mueller found the Trump campaign did not conspire with the Russian government in 2016 removes, for now, a major focus of Democrats' messaging.

But it has also given them an opening to turn to an issue they believe is more important to many voters anyway: health care.

Updated at 1:30 p.m. ET

In a significant shift, the Trump administration says the entirety of the Affordable Care Act should be struck down in the courts. Previously, the administration had pushed to remove the law's protections for people with pre-existing conditions but had not argued in court that the whole law should be struck down.

If last Friday's district court ruling that the Affordable Care Act is unconstitutional were to be upheld, far more than the law's most high-profile provisions would be at stake.

In fact, canceling the law in full — as Judge Reed O'Connor in Fort Worth, Texas, ordered in his 55-page decision — could thrust the entire health care system into chaos.

U.S. District Judge Reed O'Connor has a history of siding with Republicans on ideologically motivated lawsuits. His ruling last week, in which he sided with the GOP on a challenge to the Affordable Care Act, was not a one-off.

In fact, critics say, his history is ultimately why that case was before him in the first place.

The Affordable Care Act faces a new legal challenge after a federal judge in Texas ruled the law unconstitutional on Friday. The decision risks throwing the nation's health care system into turmoil should it be upheld on appeal. But little will be different in the meantime.

"Nothing changes for now," says Julie Rovner, chief Washington correspondent of Kaiser Health News.

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