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Judge Rules ACA Unconstitutional in State-Led Lawsuit

On Dec. 14, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas ruled that the Affordable Care Act (ACA) is unconstitutional. The ruling comes in a lawsuit brought by a group of Republican governors and attorneys general in 20 states.

The plaintiffs filed the lawsuit in February, arguing that the law’s individual mandate is unconstitutional without the tax penalty. In the Tax Cuts and Jobs Act of 2017, Congress eliminated the individual mandate tax penalty by reducing it to zero dollars but not eliminating the mandate altogether. In his ruling last week, O’Connor agreed with the plaintiffs and ruled that the individual mandate “can no longer be sustained as an exercise of Congress’ tax power.”

A group of 17 Democratic attorneys general in 16 states and Washington, D.C., were permitted to intervene in the case plan to appeal the ruling. In a statement, America’s Essential Hospitals expressed concerns that this ruling could jeopardize access to affordable health care coverage for millions of Americans.

It is important to note this ruling does not immediately impact ACA policies and programs. There likely will be additional legal challenges before any policy changes occur as a result of a final ruling.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Kelcie Jimenez is a former state policy analyst at America's Essential Hospitals.

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