Affordable Care Act declared unconstitutional

Details are scanty here: the entire text is this:

(CNN)A federal judge in Texas said on Friday that the Affordable Care Act’s individual coverage mandate is unconstitutional and that the rest of the law must also fall.

This is a breaking story and will be updated.
I guess we’ll know more tomorrow, but if you get details, by all means put them in the comments. Next stop: the Supreme Court.

56 Comments

  1. Ken Pidcock
    Posted December 14, 2018 at 8:07 pm | Permalink

    So that means that if we want universal coverage, it has to be government programs. Good to know, actually.

  2. Joseph O’Sullivan
    Posted December 14, 2018 at 8:11 pm | Permalink

    Anyone find a link to the opinion? I’ve seen breaking news from CNN and The NY Times but they didn’t provide any links to the written descision

    • Ken Kukec
      Posted December 14, 2018 at 8:27 pm | Permalink

      Here’s the opinion.

      • Adam M.
        Posted December 14, 2018 at 8:39 pm | Permalink

        I accept the reasoning, assuming the premises are true and nothing important was left out, but I can’t help but get the impression from reading that that the judge wanted to strike it down.

      • Posted December 15, 2018 at 6:31 pm | Permalink

        When I read this opinion this morning, I thought the reasoning very faulty. But I am not a legal expert. I have read the views of several legal experts now, conservative and liberal, and apparently I am right. The reasoning is nuts.

  3. Mark R.
    Posted December 14, 2018 at 8:29 pm | Permalink

    This is precisely why we need “Medicare for all”. We need to abolish the entire mess that is the US health care system. Maybe this is a non-intended first step. This issue is red-hot and will continue to be for the foreseeable future; many R’s in the last mid-term lost and will continue to lose if they stand against health-care, universal or not.

    • Historian
      Posted December 14, 2018 at 8:38 pm | Permalink

      This ruling could be political gold for the Democrats. Imagine the impact of a series of commercials during the 2020 election that parade sick people telling the nation how Trump and the Republicans are killing them. In the long run, maybe something good will come out of this sad situation. In the meantime, I remain very depressed.

      • Mark R.
        Posted December 14, 2018 at 9:27 pm | Permalink

        It is depressing. But as you noted “in the log run, maybe something good will come out of this sad situation.” I think Trump will eventually be regarded as something good coming out of a sad/bad situation. Trump’s bullshit antics have invigorated the massive voting-blocks which have been historically lazy, cynical, and disinterested. I predict in the coming years the GOP will be an endangered species.

        • Saul Sorrell-Till
          Posted December 15, 2018 at 6:00 am | Permalink

          “The GOP an endangered species”

          I hope so. But I think Donald Trump has pointed the way forward for them. Once they’ve sent him for ‘retirement’ at the glue factory they’ll just iron out the bumps in his approach and adopt a more ‘reasonable’ anti-immigrant approach. Ans the Democrats will continue to get tripped up on it, like they always do.

          Each party owns the others’ Kryptonite: the Dems own the healthcare debate, the Republicans own the immigration debate.

          And demographically the GOP are in an existential battle. They know their traditional base is being eroded. They are fighting for the life of white social conservatism as a movement. This makes them much more dangerous than the Democrats, and vastly more prone to go as low as is necessary. They are similar to Trump in that respect, which is possibly why they’ve stuck with him for longer than anyone thought they would – because both Trump and the GOP are fighting for their lives; one because of Mueller, the other because of demography. They share desperation.

          • Harrison
            Posted December 15, 2018 at 10:01 am | Permalink

            It may be a bit late for Reps to attempt to “moderate” on immigration. There’s enough pictures of tear gassing and child internment camps for Dems to campaign on for a decade. People who wanted stricter border control and were even supportive of a wall still by and large balk at some of these atrocities. And the deep red base who do love that stuff won’t stand for their party softening on any of it.

            • Posted December 15, 2018 at 11:31 am | Permalink

              With the fresh memories of the caravan, I see little reason for GOP to moderate.

          • Posted December 15, 2018 at 12:00 pm | Permalink

            I agree. It is a mystery to me that the Dem leadership doesn’t see how vulnerable lack of a rational immigration policy makes them. If There are likely disagreements among Dem leadership on the details but my guess is that they could easily be ironed out. I were their leader, I would start with a good name, perhaps “Rational Immigration Policy”. After that, it is largely a marketing problem.

            • Mark R.
              Posted December 15, 2018 at 2:23 pm | Permalink

              It is a mystery to me that the Dem leadership doesn’t see how vulnerable lack of a rational immigration policy makes them.

              I don’t agree…they’ve tried to pass bipartisan immigration reform, but the Senate can’t muster the 60 votes. Here are 3 examples:

              You got The Coons-McCain bill that provided a path to citizenship for 1.8 million undocumented immigrants who came to the US as children. It offered no money for Trump’s border wall, so the Republicans didn’t support it. Failed 52-47 (all dems supported it)

              Then there was The “Common Sense” plan that would have provided a path to citizenship for 1.8 million (like the Coons-McCain bill).
              offered $25 billion for border security and prevented DACA recipients from sponsoring their parents for legal status. Failed 54 to 45. A handful of dems went against this because of the DACA chain migration block. Trump said he would have vetoed it anyway.

              Then there was The Grassley bill that would have provided the 1.8 million a path to citizenship, offered 25 billion to fund a southern border wall, would curtail family immigration and eliminate the diversity visa lottery program. Failed 39 to 60. The dems opposed en masse as did a number of repubs. This is the bill Trump wanted…of course, the most cruel and the border wall.

              So I can’t blame the democrats for not seeking a rational immigration policy. I think the screaming right “DEMS FAULT FOR EVERYTHING” has people thinking it is the dems fault when clearly it isn’t.

              • Posted December 15, 2018 at 3:29 pm | Permalink

                I didn’t say the Dems haven’t tried to pass immigration legislation. I know they have several times, as you point out. I guess I should have stressed “coherent” more strongly. What I am accusing the Dems of is not marketing their immigration policy properly.

                When Trump and GOP claim that Dems want open borders, their response seems only to deny it. They need to remind the audience that they have proposed legislation several times, as you point out here, and none have called for open borders. Denials aren’t worth much in today’s political atmosphere where Trump denies something with each breath. They should give a good name to their proposal, a website to back it up, and give the link out at every opportunity. This is the best they can do to stop Trump and GOP from owning the immigration issue, which is really their only potent issue with voters.

              • Diane G
                Posted December 16, 2018 at 12:55 am | Permalink

                One factor getting in the way is that the press don’t find such proposals and web-sites worthy of much attention; not nearly as reader/viewer-grabbing as Trumpian hysterics.

                Reminds me of the people who said they had no idea what Hillary’s policies were, when she had more and more extensively detailed policy positions than any candidate I can remember.

              • Posted December 16, 2018 at 10:32 am | Permalink

                Since all the news outlets love to interview politicians, all they need to do is add “… and if anyone wants to know more, it is all detailed on our website, FairImmigration.com.” It is not flashy but consistency wins the day. Both the news people and the viewers get it drilled into their heads.

                With Hillary Clinton, it was all about presentation, or lack thereof. Every time I heard her speak, I would note the many ways in which what she was saying was presented poorly and could easily be improved. My memory of the details has faded but, generally speaking, she seemed to put identity politics before policy. The policy seemed as if she had dutifully filled in the blanks. She didn’t make the case that she needed to be President because she was going to do X, Y, Z. It came across that she was going to be President because she appealed to women, African-Americans, LGBTQ, etc. and that she was going to be the first female President. Trump was awful in so many ways but he was definitely all about what he was going to do if elected and telling people how he was going to fix things. That didn’t seem to motivate Clinton. Instead she had calculated exactly those policies that appealed to her base and took no risks and, worst of all, her audience could tell that she had done that.

              • Mark R.
                Posted December 15, 2018 at 3:57 pm | Permalink

                OK, thanks for the clarification. I agree with you…dems suck at marketing…and they also don’t lie pathologically (apparently a disadvantage nowadays).

              • GBJames
                Posted December 15, 2018 at 6:11 pm | Permalink

                When Trump and GOP claim that Dems want open borders, their response seems only to deny it.

                When did you stop beating your wife, Paul?

                The Republican Party, and their propaganda organs, specialize in repeating fear-inducing lies. Over and over. Democrats are more inclined to trying to actually accomplish things. I personally prefer they not rely on “marketing” to move things along.

              • Posted December 15, 2018 at 6:25 pm | Permalink

                I don’t beat my wife. Is the denial enough or do I need a supporting website? 😉

                But seriously, marketing matters. I don’t mean the slimy lies that Trump indulges in. It is really just good presentation.

              • GBJames
                Posted December 15, 2018 at 6:49 pm | Permalink

                If I were a Republican, Paul, it would not be enough. I would just spend the next ten years repeating the allegation.

                Why does Paul Topping deny stopping beating his wife?

                You yourself know that Democrats have repeatedly attempted to fix the immigration fiasco in the US. It has been repeatedly blocked by Republicans. The problem is not Democrat marketing. I don’t understand why people blame Democrats for Republican policies. I think the blame is misdirected.

        • Posted December 15, 2018 at 6:09 am | Permalink

          GW Bush screwed the world economy. Okay the social justice whingers got arrogant and all that, but it still should have taken more than 10 years before the Republicans got to recover from that.

          And yet, here they are.

  4. Historian
    Posted December 14, 2018 at 8:33 pm | Permalink

    Apparently the tax law passed last year eliminated the individual requirement to buy insurance. The Supreme Court previously upheld Obamacare because it was based on a tax, of which Congress has the power to enact. Since the tax is now gone the whole law is invalid according to this judge.

    I don’t have Obamacare, but there is nothing more infuriating to me that the right wing has done than its effort to deprive millions of people of healthcare. It is sickening (no pun intended) and sadistic. But I fear that out of ignorance many of those who may be deprived of healthcare will continue to vote for the people who want them in an early grave, including Trump.

    Maybe the Supreme Court will reverse this judge, but that’s far from a guarantee considering who is on it.

    What has this country come to?

    • Ken Kukec
      Posted December 14, 2018 at 9:02 pm | Permalink

      Funny, I can remember when rightwingers railed against “judicial activists” who “legislated from the bench.”

      The Republican US congress has never been able to muster the votes to repeal Obamacare (which the Trump administration refused to defend in this lawsuit). Now they’ve gotten a Texas trial judge to do the dirty work for them.

      Ironic, too, that Republican congresspeople — many of whom had cast dozens and dozens of meaningless votes to repeal Obamacare over the last eight years — took a look at opinion polls before the midterms and decided to run as the great defenders of the prohibition on insurance companies’ exclusion of preexisting conditions.

      What a mess.

    • Mark R.
      Posted December 14, 2018 at 9:18 pm | Permalink

      “What has this country come to?”

      Add this to the blatant power-grab of sad-loser R’s in N. Carolina, Wisconsin and Michigan; I’m observing a political party in this country that has embraced a fascist mentality. Can some states become fascist without others? This “United” states is a wreck. Thanks to the hard-line, racist, fanatic/religious, ignorant and self-loathing republican constituency, this is where we’ve landed. Good job assholes!

      And what have regressive-leftists done? Sure, let’s call them out, but it’s becoming boring in the light of Trump et al. And why the hyperbolic horrors attributed to the idiot leftists? They’re just an angry zit compared to this ruthless GOP shit.

      • Historian
        Posted December 14, 2018 at 9:30 pm | Permalink

        Indeed.

        Here is an article in Politico by a political science article entitled “When I Said North Carolina Wasn’t a Democracy, People Called Me Crazy.” The current Republican Party politicians does not believe in democracy, only power. The base of the Republican Party doesn’t believe in democracy also, particularly the evangelicals.

        https://www.politico.com/magazine/story/2018/12/08/north-carolina-9th-district-democracy-222853

      • Ken Kukec
        Posted December 14, 2018 at 9:55 pm | Permalink

        The GOP has become a permanent minority party with an ever-shrinking demographic base. Its only path for clinging to power is by maximizing its own voter turnout through appeals to fear and bias and via the ruthless use of gerrymandering, voter suppression, and the manipulation of parliamentary procedures. And it exhibits no scruples about doing so.

        • Diane G
          Posted December 15, 2018 at 2:56 am | Permalink

          Is the GOP lily white WRT Russian collusion?

          • Ken Kukec
            Posted December 15, 2018 at 7:49 am | Permalink

            This Russian Mata Hari case starring Maria Butina threatens to peel back some scabs on the GOP.

            As Dear Leader is wont to say when he has no freakin’ idea WTF he’s doing, “we’ll see what happens.”

            • Diane G
              Posted December 15, 2018 at 8:14 pm | Permalink

              Comforting to know that he’s as in the dark as we are. And I don’t even mean that sarcastically!

  5. Posted December 14, 2018 at 8:58 pm | Permalink

    The next stop is the Court of Appeals, I think.

    • Ken Kukec
      Posted December 14, 2018 at 9:04 pm | Permalink

      Yeah, the Fifth Circuit Court of Appeals, generally regarded as the nation’s most conservative.

      • Diane G
        Posted December 15, 2018 at 2:58 am | Permalink

        That any court can be known as the most conservative or the most liberal is a huge problem itself.

        • Posted December 15, 2018 at 11:32 am | Permalink

          + 1

        • Posted December 15, 2018 at 12:05 pm | Permalink

          Yes, but I think the notion of conservative vs liberal courts is largely a fiction invented by those who don’t like a court’s decisions. I’m not saying the appointing of judges by one side or the other doesn’t matter but it has mostly balanced out over the years. Of course, if you apply some liberal/conservative measure to a large number of cases, you are bound to see differences but they are small.

          • Diane G
            Posted December 15, 2018 at 10:03 pm | Permalink

            Ideally. I hope you’re correct, but the GOP machinations seem to get direr by the minute. (Of course the Dems aren’t lily-white either–though they may look so compared to opposition!)

  6. Posted December 14, 2018 at 9:41 pm | Permalink

    Without the tax pier, Zi have don’t see what the provision for restricting the insurance companies from excepting to pre-existing conditions would be based on. It cannot be based on the taxing power in the constitution as it has nothing to do with tax. Only other thing would be interstate commerce clause or the general welfare clause.

  7. Joseph O’Sullivan
    Posted December 14, 2018 at 9:46 pm | Permalink

    After a brief look I say this is all preliminary. It is a ruling by a district court judge that relies heavily on the dissent of the Supreme Court case. This will go to the appeals court where it will be decided by a group of judges. District court decisions are made by individual judges, and appeals decisions need a majority of a group of appeal court judges. Judges with outlier philosophies get out voted in appeals courts and the more conventional judges overturn unusual district court rulings. Judges and appeal court judges in particular are normally especially loathe to overrule a Supreme Court decision. The district court judge seemed to be trying a bit too hard to differentiate the case at hand with the earlier challenge to the ACA.

  8. dd
    Posted December 14, 2018 at 10:06 pm | Permalink

    I don’t understand how a single judge can make a ruling affecting so many millions.

    Yes, there is the appeals process….but still.

    • Posted December 14, 2018 at 10:10 pm | Permalink

      He can’t. His decision only affects the area in his district, which is probably less than Texas.

      • Historian
        Posted December 14, 2018 at 10:24 pm | Permalink

        No, at least per the Washington Post: “The opinion by U.S. District Judge Reed O’Connor overturns all of the sprawling law nationwide.”

        https://www.washingtonpost.com/national/health-science/federal-judge-in-texas-rules-obama-health-care-law-unconstitutional/2018/12/14/9e8bb5a2-fd63-11e8-862a-b6a6f3ce8199_story.html?utm_term=.0f3ddf2786e9

        • Posted December 14, 2018 at 10:46 pm | Permalink

          Good article. I like the quote from the legal health extert when he said the status is unclear. Our system is much to complex and complicated.
          I don’t see how a district judge has jurisdiction outside his district but who wants to question the Post.

          • Adam M.
            Posted December 14, 2018 at 11:46 pm | Permalink

            I donno, but I’m reminded of the judge in Hawaii overturning Trump’s Mexico border policies…

            • Ken Kukec
              Posted December 15, 2018 at 8:40 am | Permalink

              I think you’re thinking of the Hawaii district court decision in the “Muslim ban” case.

              • Adam M.
                Posted December 15, 2018 at 12:48 pm | Permalink

                Yes, you’re right.

          • Posted December 15, 2018 at 2:40 am | Permalink

            “District” merely refers to which judges will hear the case and that depends on the location it is filed in. A Federal district ruling covers the whole country. My layman’s take anyway. I’m sure someone else can correct me if I’m wrong.

            • Ken Kukec
              Posted December 15, 2018 at 8:36 am | Permalink

              Generally a federal district court opinion is binding only in the district in which it is decided. This case (like some of the cases in the Muslim ban litigation) has broader application because the attorneys general for several states joined the lawsuit as parties.

            • Posted December 15, 2018 at 8:43 am | Permalink

              I did some reading on juristion of district courts last night. Some of their case decisions only are good for their district but in a class action case the decision is good nationwide. Maybe a lawyer who litigates in federal courts could give a better explanation of the difference.

  9. Randall Schenck
    Posted December 15, 2018 at 7:40 am | Permalink

    As of early Saturday, the only thing I am learning is that nothing will change yet. One federal judge does not get it done and it will be appealed. So if you happen to be on the ACA you still are. Another thing about this if it should hold and eventually kill ACA, there is also a big hit against Medicaid that is currently covering many and paying drug cost for lots of old people. The whole process must make most foreigners particularly sick of all this. Hell, most people here don’t get it.

    But give people something and then take it away and see what happens.

    • Ken Kukec
      Posted December 15, 2018 at 8:44 am | Permalink

      It’s customary for the application of district court decisions invalidating federal statutes to be stayed while the case works its way through the appellate process.

      • Randall Schenck
        Posted December 15, 2018 at 9:20 am | Permalink

        What seems troubling to me about the politicians, besides everything, are democrats who point to medicare for all as being first on their agenda. That can hardly make sense considering the numbers in the senate and it is almost certain they must wait until after the next election and it’s results. Besides – Medicare is available to those who pay into it, something most seem to ignore. Those who do not, meaning normally those without any social security must get their health care if any, by other means. Seems to be overlooked by many.

  10. Harrison
    Posted December 15, 2018 at 8:55 am | Permalink

    As much as I would love to see Trump’s reaction when Kavanaugh joins Roberts in voting with the liberal justices 6-3 to reverse this decision, marking the third time the SCOTUS will have upheld the ACA, this challenge won’t make it past the Fifth Circuit.

    This scheme is both ill-fated and extremely bad optics for Republicans who were less than a month ago lying through their teeth about protecting Americans with pre-existing conditions.

  11. GBJames
    Posted December 15, 2018 at 9:20 am | Permalink

    Probably will be overturned on appeal.

    This will help advocates of some form of Medicare for all. People are growing weary of Republican efforts to eliminate healthcare for millions of people.

  12. CAS
    Posted December 16, 2018 at 12:09 pm | Permalink

    Smart short-term move by Republicans. It seems likely that the Supreme Court will uphold the well-reasoned decision.

    It may be a good thing in the long run if Obamacare is struck down. All the idiots who think the Republican are making their lives better may change their mind when their relatives with preexisting conditions can’t afford health care. In the US it seems to take disasters, like the great depression to make social progress.

  13. Nicolaas Stempels
    Posted December 17, 2018 at 3:01 am | Permalink

    I must say I find the ACA needlessly complicated, I’m sure I do not understand all the intricacies.
    The US has, quite by far, the most expensive health care in the world, without having comparable outcomes. And all that while having about the best instruments (in training, knowledge and equipment) to be the top in outcomes too.
    I think there are a few reasons for this, two of which I can think of offhand:
    – The insurance companies, whose main aim is profit, have way too much say.
    – The litigation damages awarded are extremely high, not only resulting in high premiums for the health care worker’s professional insurance, but causing a plethora of unnecessary examinations and expensive tests, since doctors want to -understandably- cover their butts.
    I’m sure there are other reasons, but addressing these two would go a long way to make health care more affordable, I’d think.

    • Posted December 17, 2018 at 10:56 am | Permalink

      I suspect that much of the ACA’s complexity was due to the need to keep the health insurance industry alive. The biggest problem with introducing universal healthcare in the US is the “can’t get there from here” problem. There are going to be losers in the health care monstrosity and they are going to fight any big change with every lobbying dollar they can muster.

  14. Posted December 17, 2018 at 11:57 am | Permalink

    Brian Leiter links to some opinions on this.


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