By Frederick H. Lowe
The Patient Protection and Affordable Care Act, which has dramatically improved the health insurance coverage rates for African Americans since its enactment, has been ruled unconstitutional by a federal judge in Texas, setting off a major battle.
Supporters of the Affordable Care Act, known as Obamacare, which was enacted by the 111th Congress and signed into law by President Barack Obama on March 23, 2010, is considered the most-sweeping change to the nation’s health care system since the introduction of Medicare and Medicaid in 1965.
The legislation passed by only Democratic members of Congress prohibits insurers from denying coverage to individuals due to pre-existing conditions. States are required to ensure the availability of insurance for individual children who did not have coverage via their families. prohibits insurers from denying coverage to individuals due to pre-existing conditions.
In a 55-page ruling in the case titled, Texas v United States, Judge Reed C. O’Connor of the Northern District of Texas in Fort Worth, wrote that a tax bill passed by Congress last December, which eliminated the penalty for not having insurance, rendered the Obamacare unconstitutional.
The U.S. Supreme Court in a 5 to 4 decision in 2012 upheld ACA based on the view that the penalty for not having insurance was a tax and thus the law was valid because it relied on appropriate power allowed Congress under the U.S. Constitution. Without the tax, Judge O’Connor ruled the law was no longer Constitutional.
“In some ways, the question before the Court involves the intent of both the 2010 and 2017 Congresses. The former enacted the ACA. The latter sawed off the last leg it stood on,” O’Connor wrote.
President Donald Trump praised the ruling. Trump urged the incoming Speaker of the House Nancy Pelosi and Senate Majority Leader Mitch McConnell to fix the problem.
The ACA was Obama’s signature legislation and he expects the decision to be overturned.
Senate Minority Leader Chuck Schumer said in a statement, “The ruling seems to be based on faulty legal reasoning and hopefully, it will be overturned.”
Many legal experts agreed with Schumer’s point of view. “This is insanity in print, and it will not stand up on appeal,” Professor Nicholas Bagley, of the University of Michigan Law School, tweeted.
An appeal will be made before the Fifth Circuit Court of Appeals, which is based in New Orleans.
The law has had a major impact in lowering the uninsured rate by more than one-third between 2013 and 2016, from 18.9 percent to 11.7 percent for African Americans, according to the Center for Budget and Policy Priorities, a progressive American think tank based in Washington, D.C.
“African Americans have higher uninsured rates than whites (7.5 percent) and Asian Americans (6.3 percent),” wrote the Center for Budget and Policy Priorities. “Nonelderly African Americans have death rates that are more than 40 percent higher than their white counterparts and are more likely to have diseases like high blood pressure, diabetes, and stroke at younger ages.”
The law’s effectiveness has been limited by states refusing to expand Medicaid. “In 2015, the uninsured rate for African Americans was at or below the national average of 12.1 percent in 25 of the 28 states that had expanded Medicaid,” wrote the Center on Budget and Policy Priorities. “Among the 10 states with largest African American populations, the non expansion states all had significantly higher uninsured rates among American Americans than the expansion states. For example, 17.3 percent of African Americans are uninsured in Florida, which didn’t expand Medicaid, and 7 percent of African Americans are uninsured in California, which did.”
Some 20 million people have health insurance under ACA and if the ruling is not repealed, they would lose their health coverage. A decision on the appeal could take as long as a year.