Federal appeals court questions legality of Obamacare insurance mandate

Latest 'Obamacare' Court Battle Plays out in New Orleans

The appeals court case, heard in New Orleans on Tuesday, may also complicate the legacy of the chief justice, who has attempted to keep the Supreme Court out of politics but could soon face another presidential election-year health care dispute.

The fate of former President Barack Obama's signature health care law, and its coverage and insurance protections for millions of Americans, is again being argued before a panel of judges - this time a federal appeals court in New Orleans.

Judge Kurt Engelhardt questioned why the act is still constitutional without the tax, and why a severability clause was not included. But it argued on appeal that rest of the law can not be severed.

Like this story? Subscribe to FierceHealthcare! "This is the silver bullet that's going to undo the ACA?'" she asked. In a filing with the court late last week, Justice Department attorneys argued that perhaps the health law should be invalidated only in the GOP states that are suing, rather than all states.

Judge Jennifer Elrod, appointed by President George W. Bush, asked if lawmakers meant to knock down the law when they ended the penalty for not having coverage as part of the 2017 tax overhaul.

Among the arguments by the law's supporters: Those who filed suit have no case because they aren't harmed by a penalty that doesn't exist; the reduction of the tax penalty to zero could be read as a suspension of the tax, but the tax's legal structure still exists; and even if the individual mandate is now unconstitutional, that does not affect the rest of the law known as the Affordable Care Act. The third judge on the panel, Carolyn Dineen King, was appointed by President Jimmy Carter.

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We will vote unambiguously for a party that supports remaining in the EU. "No, I want to take the movement with me". He said: "We will decide very quickly at the start of that campaign exactly what our position will be".

The five conservatives, including Roberts, were appointed by Republican presidents. "If this is no longer a tax, then what happens?" Elrod asked several questions about which provisions were more directly connected to the individual mandate.

When the administration first weighed in on the case, in June 2018, it said it believed that without the tax penalty only the ACA provisions most closely connected to that penalty - including requiring insurers to sell policies to people with preexisting conditions - should be struck down.

The case will likely be appealed to the Supreme Court, which would raise the stakes for both the law's future and its use as a political tool ahead of the 2020 election. A third, appointed by Democratic President Jimmy Carter, stayed silent throughout the almost two-hour oral argument hearing in New Orleans, which follows a December decision by federal Judge Reed O'Connor of the Northern District of Texas calling for the law to be struck down. And he said Supreme Court precedent dictates that the courts should strive to uphold as numerous law's provisions as possible. However, Hawkins took pains to highlight inconsistencies that have developed in the Trump administration's position, which left Flentje, the Justice Department lawyer, occasionally struggling to explain himself. "Make no mistake: this lawsuit is yet another politically-charged attempt by Republicans to sabotage New Mexicans' health care - this time, via the courts".

The hearing wrapped up this afternoon, and while both sides were heard in court, a ruling is not expected to come today. Rob Henneke, general counsel for the Texas Public Policy Foundation, which represents two individual plaintiffs that joined the red states in arguing the ACA is unconstitutional, took a victory lap on a call with reporters after the hearing.

Legal scholars, including many on the right, have always been dubious about Texas' arguments, particularly on the question of severability.

Why it matters to patients and physicians: A Texas-led coalition of 20 states argued that, because Congress reduced the individual tax penalty down to $0, the entire ACA should be eliminated also.

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