Federal ACA Ruling to Be Appealed by Coalition of California, Democratic-Led States

As expected, California and 16 other states defending the Affordable Care Act (ACA) in a federal lawsuit announced they will appeal last month’s ruling by a Texas judge that declared the ACA unconstitutional. California Attorney General Xavier Becerra said a notice of appeal was filed Thursday.

On Sunday, the federal judge in the case, Reed O’Connor of the Federal District Court in Fort Worth, issued a stay in the case and said that the ruling should not go into immediate effect “because many everyday Americans would otherwise face great uncertainty” during an appeal. On December 14, 2018, he ruled that the ACA's individual coverage mandate is unconstitutional and that the rest of the law must also fall.

Becerra said the ruling “threatens the entire healthcare system in the United States of America.” He was joined on a media call by Oregon Attorney General Ellen F. Rosenblum, Virginia Attorney General Mark R. Herring, and Colorado Attorney General—Elect Phil Weiser. Rosenblum said the ruling was “legally flawed.”

The states filed the notice of appeal with the US Court of Appeals 5th Circuit. If the appeals court allows the lower court ruling to stand, it would be heard by a Supreme Court remade by President Trump, who appointed conservative jurist Brett Kavanaugh. The attorneys general said they did not have a timeframe for when the 5th Circuit would hear the case, and they declined to make any predictions about what would happen if the case goes to the Supreme Court.

The decision in the case, Texas v Azar, was made in favor of the 20 Republican-led states that sued the federal government over the constitutionality of the ACA.

Plaintiffs led by Texas Attorney General Ken Paxton tied their argument to the Supreme Court’s 2012 ruling that upheld the ACA, in which Chief Justice John G. Roberts Jr wrote that the penalty for Americans who do not carry health insurance is constitutional because Congress has the power “to impose a tax on those without health insurance.”

But that tax was removed as part of the 2017 tax overhaul plan that Congress passed and President Trump signed a year ago. The penalty will be eliminated in January, although some Republicans have discussed passing legislation to require coverage for pre-existing conditions. Polls have shown that this is the most popular part of the ACA, after the provision that requires insurers to allow young adults to stay on family plans until they are 26 years old.