Texas et al v. USA; USDC Northern Texas; ACA Constitutionality

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Addie
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Texas et al v. USA; USDC Northern Texas; ACA Constitutionality

#1

Post by Addie »

Thread title changed

----------------------------

BuzzFeed News
A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

In a controversial ruling, a Texas judge has ruled that a minor move by Congress last year is grounds to strike down the entire Affordable Care Act, including pre-existing condition protections.


WASHINGTON — A federal judge in Texas ruled Friday night that the Affordable Care Act must be thrown out in its entirety, a decision that could lead to millions of people losing their health insurance.

In a dramatic ruling that flies in the face of what most legal experts had argued, US District Judge Reed O’Connor, who sits in Fort Worth, found that a tweak to the Affordable Care Act that Congress made last year makes a key part of the law unconstitutional, which means that the rest of the law, including popular provisions such as protections for people with pre-existing health conditions, is invalid.

California Attorney General Xavier Becerra and a coalition of Democratic state attorneys general who intervened in the case to defend the Affordable Care Act are expected to appeal the ruling, and are likely to seek a delay of the ruling while they take the case up to the US Court of Appeals for the Fifth Circuit. O'Connor did not stay his ruling pending any appeal as part of his Friday night order.

If O'Connor's decision ultimately stands, it could throw the insurance markets into chaos and return America to the days when insurance companies could refuse insurance to people with pre-existing conditions or charge them exorbitant premiums. It is the most recent of many legal challenges to the ACA, also known as Obamacare, and will likely be appealed to the Supreme Court.

The lawsuit was launched by 20 Republican state attorneys general early this year after Congress effectively eliminated the ACA’s individual mandate. Led by Texas, the states argued this rendered the entire ACA is unconstitutional.
Adding:
WaPo: Federal judge in Texas rules Obama health-care law unconstitutional
Politico: Judge rules Obamacare unconstitutional, endangering coverage for 20 million
New York Times: Texas Judge Strikes Down Obama’s Affordable Care Act as Unconstitutional

batguano
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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#2

Post by batguano »

Right. Because the Constitution requires all doctors be able to afford a Lamborghini

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Mikedunford
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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#3

Post by Mikedunford »

Ruling here:
https://www.courtlistener.com/recap/gov ... .211.0.pdf

Best Twitter thread on the subject that I've seen so far:


Bagley is right regarding the inanity of ruling the whole act, including the parts about things like calorie counts at fast food chains, unconstitutional. (Something I missed in my initial reactions on Twitter.) I'm less optimistic about guaranteed coverage and community rating. The reasoning there might well stand on appeal.

There's no injunction, so it's not clear what the immediate effects will be.
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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#4

Post by Mikedunford »

batguano wrote:
Fri Dec 14, 2018 9:00 pm
Right. Because the Constitution requires all doctors be able to afford a Lamborghini
It's got fuck-all to do with doctor incomes. I don't think the ACA has had much effect on those. Insurance executive compensation is a different matter.
"I don't give a fuck whether we're peers or not."
--Lord Thomas Henry Bingham to Boris Johnson, on being asked whether he would miss being in "the best club in London" if the Law Lords moved from Parliament to a Supreme Court.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#5

Post by batguano »

Mikedunford wrote:
Fri Dec 14, 2018 9:03 pm
batguano wrote:
Fri Dec 14, 2018 9:00 pm
Right. Because the Constitution requires all doctors be able to afford a Lamborghini
It's got fuck-all to do with doctor incomes. I don't think the ACA has had much effect on those. Insurance executive compensation is a different matter.
You dont know very many American doctors, obviously.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#6

Post by Somerset »

batguano wrote:
Fri Dec 14, 2018 9:04 pm
Mikedunford wrote:
Fri Dec 14, 2018 9:03 pm
batguano wrote:
Fri Dec 14, 2018 9:00 pm
Right. Because the Constitution requires all doctors be able to afford a Lamborghini
It's got fuck-all to do with doctor incomes. I don't think the ACA has had much effect on those. Insurance executive compensation is a different matter.
You dont know very many American doctors, obviously.
Err......

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#7

Post by Mikedunford »

batguano wrote:
Fri Dec 14, 2018 9:04 pm
Mikedunford wrote:
Fri Dec 14, 2018 9:03 pm
batguano wrote:
Fri Dec 14, 2018 9:00 pm
Right. Because the Constitution requires all doctors be able to afford a Lamborghini
It's got fuck-all to do with doctor incomes. I don't think the ACA has had much effect on those. Insurance executive compensation is a different matter.
You dont know very many American doctors, obviously.
:rotflmao: :rotflmao: :rotflmao: :rotflmao: :rotflmao:
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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#8

Post by Addie »

Thanks, Mike.
Mikedunford wrote:
Fri Dec 14, 2018 9:02 pm
Ruling here:
https://www.courtlistener.com/recap/gov ... .211.0.pdf

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#9

Post by Mikedunford »

For anyone interested, physician salaries have actually been rising slightly post-ACA.
https://www.forbes.com/sites/brucejapse ... 5e69683afa

Which is about what one should expect, if one applies just a modicum of common sense. More people with insurance coverage means more people go to the doctor, which means more money for the doctors - if only because fewer patient accounts wind up in collections.
"I don't give a fuck whether we're peers or not."
--Lord Thomas Henry Bingham to Boris Johnson, on being asked whether he would miss being in "the best club in London" if the Law Lords moved from Parliament to a Supreme Court.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#10

Post by Somerset »

Mikedunford wrote:
Fri Dec 14, 2018 9:14 pm
For anyone interested, physician salaries have actually been rising slightly post-ACA.
https://www.forbes.com/sites/brucejapse ... 5e69683afa

Which is about what one should expect, if one applies just a modicum of common sense. More people with insurance coverage means more people go to the doctor, which means more money for the doctors - if only because fewer patient accounts wind up in collections.
So your wife will be buying you Lamborghini, right ;)

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#11

Post by Mikedunford »

Somerset wrote:
Fri Dec 14, 2018 9:17 pm
Mikedunford wrote:
Fri Dec 14, 2018 9:14 pm
For anyone interested, physician salaries have actually been rising slightly post-ACA.
https://www.forbes.com/sites/brucejapse ... 5e69683afa

Which is about what one should expect, if one applies just a modicum of common sense. More people with insurance coverage means more people go to the doctor, which means more money for the doctors - if only because fewer patient accounts wind up in collections.
So your wife will be buying you Lamborghini, right ;)
She's primary care. Lambos are a bit out of the price range, even without taking that whole government salary thing into account.


I might be able to get away with a 500 Abarth, though. That's similarish, right?
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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#12

Post by ZekeB »

batguano wrote:
Fri Dec 14, 2018 9:04 pm
You dont know very many American doctors, obviously.
Oh my. Somebody knows squat little about Mikedunford. :o
Trump: Er hat eine größere Ente als ich.

Putin: Du bist kleiner als ich.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#13

Post by RoadScholar »

American doctors don’t buy their wives Lamborghinis.

American preachers do.
The bitterest truth is healthier than the sweetest lie.
X3

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#14

Post by Mikedunford »

ZekeB wrote:
Fri Dec 14, 2018 9:27 pm
batguano wrote:
Fri Dec 14, 2018 9:04 pm
You dont know very many American doctors, obviously.
Oh my. Somebody knows squat little about Mikedunford. :o
It's not a sin - batguano has only been a member since October, and I don't think it's come up, so no reason to know, really. (And I apologize for the laughing emojis, should have just explained then.)

batguano: here's the tl:dr summary.
I came here initially because my wife, a military doctor, had deployed with a birther doctor who was being court-martialed for refusing to deploy because Obama was illegal. Stayed. Went to law school in part because of encouragement from lawyers here. Decided I like the academic side of law, and especially the problems that come when transnational groups of people (kind of like this place) are interacting in an apparently borderless way but against a framework of inconsistent and sometimes conflicting national laws. Am now doing a UK-based PhD in intellectual prop law with a thesis that touches on that subject.

So I do know a few American doctors.
"I don't give a fuck whether we're peers or not."
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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#15

Post by Mikedunford »

RoadScholar wrote:
Fri Dec 14, 2018 9:38 pm
American doctors don’t buy their wives Lamborghinis.

American preachers do.
:fingerwag: :fingerwag:
"I don't give a fuck whether we're peers or not."
--Lord Thomas Henry Bingham to Boris Johnson, on being asked whether he would miss being in "the best club in London" if the Law Lords moved from Parliament to a Supreme Court.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#16

Post by batguano »

My only point was the ones I.know all hate Obamacare because they want to buy and/or pay off said Italian vehicles. I have little sympathy for them. And their belief that Obamacare was going to make them all poor may very well be ill founded. But they sure believe.


No.offense to Dunford.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#17

Post by Mikedunford »

batguano wrote:
Fri Dec 14, 2018 9:55 pm
My only point was the ones I.know all hate Obamacare because they want to buy and/or pay off said Italian vehicles. I have little sympathy for them. And their belief that Obamacare was going to make them all poor may very well be ill founded. But they sure believe.


No.offense to Dunford.
None taken. (I was mildly amused, but that's all.)

Yeah, there are some doctors who believe that. I know a couple. The majority of the doctors I know don't fall into that group, but most of them have spent time practicing within the part of the American healthcare system that comes closest to socialized medicine.

The doctors who believe that Obamacare was going to make them poor are doubly stupid. They're stupid first for failing to consider the effect of more people being able to afford their services, and stupider yet for failing to take into account that they're probably going to do a lot better under Obamacare, where the market still largely sets prices for care, than under something like a single-payer system.
"I don't give a fuck whether we're peers or not."
--Lord Thomas Henry Bingham to Boris Johnson, on being asked whether he would miss being in "the best club in London" if the Law Lords moved from Parliament to a Supreme Court.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#18

Post by Dan1100 »

I haven't read the opinion, but I take it that if Congress was to reinstate the penalty "tax" (even if it was only a nominal amount) for not having health insurance, then the previous decision would control and we'd be back to the status quo. Is that right?

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#19

Post by Mikedunford »

Dan1100 wrote:
Fri Dec 14, 2018 10:29 pm
I haven't read the opinion, but I take it that if Congress was to reinstate the penalty "tax" (even if it was only a nominal amount) for not having health insurance, then the previous decision would control and we'd be back to the status quo. Is that right?
That's my read. They could set it at a penny and let people round down and things would be fine as far as I can tell.
"I don't give a fuck whether we're peers or not."
--Lord Thomas Henry Bingham to Boris Johnson, on being asked whether he would miss being in "the best club in London" if the Law Lords moved from Parliament to a Supreme Court.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#20

Post by SLQ »

At this point, I'm ambivalent about the system that Obamacare has become under the evil republican rule. I buy (or should buy) my insurance on the WA exchange (which is one of the better ones in the country, being ruled by evil libruls.) In the beginning, I was eligible for a small subsidy and got a great plan. Very low deductible (like $250), low co-pays for pretty much everything ($10 primary care visit, $10 PT), and co-pays not subject to the deductible. My premium was something like $70 per month. I paid $60 for 2 MRIs, for example.

republican "Obamacare" is paying $335 a month for the privilege of having almost no coverage for a minor injury.

This year, I didn't qualify for a subsidy, paid $460/month premium. $7,000 deductible (best I could get -- there was NO plan under $5,500 deductible). I broke (split, actually) a bone in my hand in June, literally the only time I saw a doctor in 2018. It was a very minor "break." No surgery or pins or anything. I was supposed to have 3 visits to my primary care physician before being subject to the deductible. However, it did not work out that way. I could not get in to my primary care physician because it was a weekend, so I went to urgent care. Insurance paid: $120 (for the urgent care visit and splinting -- I paid $40, plus I paid for the X-rays, something like $80 total). All told, I paid: $1,900. Seeing the orthopedic doctor was not considered a visit to a specialty doctor, which would have had only a co-pay of $60. The orthopedic visit and putting the cast on and taking it off was considered "surgery" subject to the deductible, so I paid 100%. I also paid 100% for the x-rays. I am told that even if I had gone to my primary care physician to have the cast put on and taken off (if they would have done it), it would have been billed as "surgery," and would not have counted as a primary care visit. I stopped paying the premium so I could pay toward the bill. I did my own physical therapy, from the interwebz. I currently have no insurance.

Now? It's just as bad. For 2019, because my dad is living with me, I qualify for a hefty subsidy. However, because the plans are so expensive, the best I can do is pay $335/month for a plan that has $30 co-pays for primary care, $60 for specialty, and $100 for urgent care, not subject to the deductible. Generic prescriptions and preferred prescriptions are covered, not subject to the deductible ($15 and $50 co-pays, respectively). Chiropractic and mental health have limited visits subject to a $60 and $30 co-pay. Other than that, I pay for everything 100%, until the $7,050 deductible is met. Other than the preventive care labs, I pay 100% for labs, x-rays, etc. There are no available plans with a deductible of less than $5,500. If I were to have another simple break or a short hospital stay, I will end up paying almost the whole thing again.

The repubs have stripped Obamacare, and the insurance companies have gouged customers, to the point that it is a toss-up as to whether it is better to have insurance or not have it, for those of us who need an individual plan. So I don't really care if it stays or goes. It's next to useless. I realize that those who have a full subsidy or expanded medicaid may have a different view.

Single. Payor.

Image

Edit: Clarify
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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#21

Post by Dan1100 »

RoadScholar wrote:
Fri Dec 14, 2018 9:38 pm
American doctors don’t buy their wives Lamborghinis.

American preachers do.


Best way to drive your camel through the eye of a needle is always in a Lambo.




https://twitter.com/thehill/status/1073720555105329162

The HillVerified account @thehill

Megachurch pastor defends buying wife $200,000 Lamborghini for anniversary after backlash http://hill.cm/m1LN6eI


It isn't even a cool Lamborghini, it is some sort of lame crossover SUV Lamborghini.

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#22

Post by Chilidog »

Mikedunford wrote:
Fri Dec 14, 2018 10:37 pm
Dan1100 wrote:
Fri Dec 14, 2018 10:29 pm
I haven't read the opinion, but I take it that if Congress was to reinstate the penalty "tax" (even if it was only a nominal amount) for not having health insurance, then the previous decision would control and we'd be back to the status quo. Is that right?
That's my read. They could set it at a penny and let people round down and things would be fine as far as I can tell.
If the original law was constitutional, and they passed a second law that made it unconstitutional. Why is the original law struck down instead of the second law?

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#23

Post by Sam the Centipede »

Not a lawyer, but my understanding of contracts, statutes, regulations, etc. is that minor imperfections or irregularities can render a clause or two invalid or unenforceable but that's all. Surely it needs a major problem, such as illegal purpose or ultra vires to invalidate completely, doesn't it?

Without knowing the judge or more background, this seems like a political decision by a Republican-leaning judge. Is that interpretation unfair?

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Re: A Federal Judge Just Ruled That The Affordable Care Act Is Unconstitutional

#24

Post by Addie »

New York Times OpEd - Cristian Farias
A Partisan Ruling on Obamacare

A decision by a judge in Texas striking down the totality of the Affordable Care Act has little basis in law. ...


This all-out assault on health care is one reason Democrats did so well in the midterm elections, as voters rejected anti-Obamacare candidates at the polls. They included several lawmakers who had gleefully voted for Mr. Trump’s tax bill less than a year earlier.

Except the tax bill did not invalidate the Affordable Care Act — it did away only with the penalty for not being insured. Congress left the rest of the law intact.

Instead of respecting that legislative choice, Judge O’Connor proceeded to find all the operative provisions of the A.C.A. “inseverable” from the hollowed-out individual mandate. The whole law must fall. He gave the Texas-led challengers precisely what they wanted.

This partisan, activist ruling cannot stand. If it’s not reversed by the conservative United States Court of Appeals for the Fifth Circuit, then it’s off to the Supreme Court, where all five justices who, in 2012, already determined that the Affordable Care Act was constitutional will still be there.

One of them is Chief Justice John Roberts, who made a splash last month when he appeared to rebuke Mr. Trump’s criticism of judges who don’t rule as the president likes. The president this time around is rejoicing over Obamacare’s apparent demise — and is heaping praise on the “highly respected judge” who was itching to do Republicans’ bidding. (The White House, in a modicum of decency, has said the law will stay put as the appeal moves through the courts.)

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Re: Texas et al v. USA; USDC Northern Texas; ACA Constitutionality

#25

Post by Addie »

Cross-posting

Business Insider
Democrats react with fury after federal judge rules that Obamacare is unconstitutional

Democrats responded with fury on Friday night after a federal judge in Texas ruled that key provisions in the Affordable Care Act, or "Obamacare," were unconstitutional— rendering the entire law unconstitutional. ...

The judge ruled the individual mandate was unconstitutional, and because it is "essential to and inseverable from the remainder of the ACA" the entire law is invalid.

The ruling could impact millions of Americans, including those with preexisting conditions. Since there is no injunction from the court, it is possible, one expert tweeted, that the law could stay in place while the ruling is appealed — and lawmakers like House Minority Nancy Pelosi have stated that the decision would be appealed.
House Minority Leader Nancy Pelosi: "While the district court's absurd ruling will be immediately appealed, Republicans are fully responsible for this cruel decision and for the fear they have struck into millions of families across America who are now in danger of losing their health coverage. When House Democrats take the gavel, the House of Representatives will move swiftly to formally intervene in the appeals process to uphold the life-saving protections for people with pre-existing conditions and reject Republicans' effort to destroy the Affordable Care Act."
Senate Minority Leader Chuck Schumer: "If this awful ruling is upheld in the higher courts, it will be a disaster for tens of millions of American families, especially for people with pre-existing conditions. The ruling seems to be based on faulty legal reasoning and hopefully it will be overturned. Americans who care about working families must do all they can to prevent this district court ruling from becoming law."

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