It should be remembered that the Affordable Care Act (ACA), popularly known as Obamacare, required individuals to carry health insurance under penalty of a tax (the “personal mandate”), and required insurance companies to cover people with pre-existing conditions. Getting more people into the pool was considered necessary to make that requirement possible. It should also be remembered that the Republicans in Congress abolished the personal mandate.
Last week, a federal judge in Texas ruled that the entire ACA is unconstitutional because the personal mandate was a necessary prop, and that without the personal mandate, none of the rest of it can hold up. However, that judge did not issue an injunction stopping the ACA from continuing to operate pending appeal. So it’s going to be higher courts, probably ultimately the Supreme Court, that will decide on it.
While the personal mandate and the pre-existing conditions provision were the best known parts of the act, there’s a lot more to the ACA than that. Large parts of it have nothing at all to do with the personal mandate, including the option for states to expand eligibility for Medicaid and the ability of parents to keep their young adult children on their health policies. The Texas judge’s ruling is therefore extremely questionable. What is more, the five justices who voted to keep Obamacare in operation back in 2012 are still on the Supreme Court now. So there’s a fair chance that at least some of the Obamacare provisions will stay in effect.
Politico article, December 14, 2018
Politico analysis, December 17, 2018
NPR interview with a key Obama advisor, December 17, 2018