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Health care sector roils after ACA court ruling

Health care sector roils after ACA court ruling

"On the assumption that the Supreme Court upholds, we will get great, great health care for our people", President Trump told reporters during a visit Saturday to Arlington National Cemetery.

But Republicans, still stinging from their loss of the House in the midterm elections, are facing a fresh political quandary after U.S. District Judge Reed O'Connor said the entire 2010 health law was invalid.

"We have a chance, working with the Democrats, to deliver great HealthCare!" It's unclear what form that would take, or if the Republican-majority Senate would go along and Trump would sign it. Texas has the highest number of children without health care coverage in the country, a recent report showed, and the highest overall uninsured rate in 2016.

The head of the federal Centers for Medicare and Medicaid Services (CMS), which oversees the Affordable Care Act, said there were no changes and exchanges were open for business. Leerink analyst Ana Gupte expects the judge's decision will be overturned either by the Fifth Circuit Court of Appeals next year or the Supreme Court in 2020.

The White House applauded O'Connor's ruling, but said the law remains in place while appeals proceed. "There will be no impact to enrollees' current coverage or their coverage in a 2019 plan".

In his tweet, Trump sought to make the case, as he first did over the weekend, that the ruling presented an opportunity for his Republican administration to work with Democrats to craft a better law than President Barack Obama's signature achievement, which Trump continued to criticize. After Congress repealed the individual mandate in 2017, O'Connor said the rest of the law fell apart. The original mandate was upheld in previous court rulings as a tax.

Under Obamacare, individuals without insurance through their employer or a government program such as Medicare were required to purchase health coverage from a private insurer on the ACA's marketplace or pay a tax penalty.

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Maryland Attorney General Brian Frosh launched a counterattack September 13 to save Obamacare, seeking a judgment that the Affordable Care Act is constitutional and a court order barring the USA from taking any action inconsistent with that conclusion.

Two days after the November 6 U.S. congressional elections, a Reuters/Ipsos national opinion poll found that healthcare was the top issue Americans wanted the U.S. Congress to address.

House Democratic leader Nancy Pelosi commented on Friday following the decision: "Tonight's district court ruling exposes the monstrous endgame of Republicans' all-out assault on people with preexisting conditions and Americans' access to affordable health care".

On Friday, O'Connor ruled that after Trump signed a $1.5 trillion tax bill passed by Congress previous year that eliminated the penalties, the individual mandate could no longer be considered constitutional.

Timothy Jost, a health law expert and emeritus professor at Washington and Lee University School of Law in Virginia, said it was "silly" and "irresponsible" for O'Connor to find that the individual mandate could not be separated from the rest of the ACA. He had been asked explicitly to do just that, by lawyers for the 19 states that had filed the lawsuit against Obamacare, but the federal government - while otherwise supporting the challengers on key points - asked the judge to avoid such an order (technically, an "injunction") and instead urged him to issue only a declaratory ruling. But, "O'Connor is so far off the reservation here that virtually any (appeals) panel will reverse him", Jost said. They claimed that when Congress previous year repealed the tax penalty for the so-called individual mandate, it eliminated the U.S. Supreme Court's rationale for finding the ACA constitutional in 2012.

"Justice Roberts and a conservative court has already ruled that the Affordable Care Act is constitutional", Klobuchar said, saying the Supreme Court is unlikely to uphold the judge's ruling, which was issued on Friday.

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