WASHINGTON — A federal appeals court on Wednesday struck down a central provision of the Affordable Care Act, ruling that the requirement that people have health insurance was unconstitutional. But the appeals panel sent the case back to a federal district court in Texas to determine whether other provisions of the law could continue to exist without the mandate.
The 2-1 decision, by a panel of the United States Court of Appeals for the Fifth Circuit in New Orleans, left the fate of the nearly decade-old health law in limbo even as medical costs and insurance coverage have become central issues in the presidential race.
The ruling was issued almost exactly a year after Judge Reed O’Connor of the Federal District Court in Fort Worth struck down the entire law.
Two of the three judges, Jennifer Walker Elrod, appointed by President George W. Bush in 2007, and Kurt Engelhardt, appointed by President Trump in 2018, wrote the ruling. The third, Carolyn Dineen King, appointed by President Jimmy Carter in 1979, dissented.
Read the court’s ruling on Obamacare
A panel of the U.S. Court of Appeals for the Fifth Circuit struck down the individual mandate of the Affordable Care Act on a 2-1 decision.
A central question in the case was whether the Affordable Care Act’s “individual mandate” requiring most Americans to buy health insurance or pay a penalty became unconstitutional after Congress reduced the penalty to zero dollars as part of the tax overhaul bill enacted in 2017. When the Supreme Court upheld the mandate in its landmark 2012 ruling that saved the law, it was based on Congress’s power to impose taxes.
But a second, much more consequential question was whether, if the mandate were ruled unconstitutional, the entire law — including popular protections for people with pre-existing medical conditions, subsidies to help people afford health coverage and other measures — had to fall. Judge O’Connor ruled that it did, but the appeals panel asked him to “explain with more precision” which pieces of the law could not survive without the mandate.
A longstanding legal doctrine called “severability” holds that when a court excises one provision of a statute, it should leave the rest of the law in place unless Congress explicitly stated that the statute could not survive without that provision.
The appellate judges also asked Judge O’Connor to consider a proposal that the Justice Department, which had sided with the states seeking to overturn the law, put forth earlier this year: to block only the parts of the law found to injure those states. They include Texas and 17 other states with Republican governors or attorneys general, and two self-employed men in Texas who say the law still requires them to purchase health insurance that they otherwise would not buy, even though there is no longer a penalty for going uninsured.
“Having concluded that the individual mandate is unconstitutional, we must next determine whether, or how much of, the rest of the A.C.A. is severable from that constitutional defect,” the ruling said.
This is a developing story. Check back for updates.
