Despite court ruling, Obamacare still on for now

There will be no immediate health coverage impact from a federal judge's ruling late Friday that the Affordable Care Act is unconstitutional, but the issue is certain to take center stage again in Congress as newly elected Democrats campaigned to widen access and Iowa Republican Sen. Chuck Grassley said he'll convene hearings on finding a 'better way” to insure Americans.

U.S. District Judge Reed O'Connor in Fort Worth, Texas, on Friday sided with a coalition of 20 states that argued requiring people to pay for insurance coverage is illegal because a change in tax law last year eliminated a penalty for not having health insurance.

Republicans have opposed the 2010 law popularly known as Obamacare - the signature domestic policy achievement of President Barack Obama - since its inception but have repeatedly failed to repeal it.

In 2017, House and Senate Republicans advanced plans to scale back Obamacare, but even though the GOP held majorities in each chamber the party effort failed. Grassley, who at the time voted for measures to unravel the Affordable Care Act, announced Saturday on Twitter he will hold hearings after he becomes chairman of the Senate Finance Committee next month.

'Iowans who rely on coverage from Ocare shldn't worry abt losing their insurance while the courts settle issue but in meantime congress shld figure out better way 2insure Americans at lower cost +better quality. Ocare is fatally flawed Finance cmte will hold hrgs on ACA nxt Cong,” the senator tweeted.

Both of Iowa's newly elected Democratic representatives - Abby Finkenauer of the 1st District and Cindy Axne of the 3rd District - campaigned on supporting a 'public option” for health insurance.

That idea, which was rejected by a Democratic Congress when it passed Obamacare, has gained credence with progressive Democrats who say they'll push for it again, though critics says it's a federal budget debacle.

Under a public option, consumers would be able to choose a government funded Medicare-type plan instead of a plan from a private company.

Judge O'Connor's decision was issued the day before the end of a 45-day sign-up period for 2019 health coverage under the Affordable Care Act.

The Trump administration's head of the Centers for Medicare and Medicaid Service, which oversees the Affordable Care Act, said the exchanges remained open for business.

'We expect this ruling will be appealed to the Supreme Court,” Seema Verma, CMS administrator, said Saturday on Twitter. 'Pending the appeal process, the law remains in place.”

Consumers visiting the healthcare.gov website to sign up for insurance under the law were greeted with a crimson banner after the ruling: 'Court's decision does not affect this season's open enrollment.”

The ruling underscored the high political stakes involved in America's partisan divide over health care policy, especially for President Donald Trump and fellow Republicans in the 2020 presidential election.

Dismantling Obamacare would be a political victory for the Republicans, but it would also likely strip millions of Americans' of their health insurance coverage, a policy problem for which Republicans have no clear solution.

About 11.8 million consumers nationwide enrolled last year for 2018 Obamacare plans.

Enrollment for 2019 plans was expected to dip as the Trump administration curtailed advertising and outreach. In the first month of open enrollment from Nov. 1 to Dec. 1, over 3 million Americans - including about 19,000 Iowans - bought health insurance on the exchange.

The U.S. Supreme Court upheld the Affordable Care Act in 2012.

But Friday, O'Connor ruled that after Trump signed a $1.5 trillion tax bill passed by Congress last year, the individual mandate requiring that most Americans obtain health insurance or pay a tax was no longer constitutional.

He said because the individual mandate was an 'essential” part of Obamacare, the entire law, rather than just the individual mandate, was unconstitutional.

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 act.

He said judges who find portions of a law invalid are required 'to do as little damage as possible” to the rest of the law.

Jost noted that the 5th U.S. Circuit Court of Appeals, which will hear any appeal in the case, is considered the most conservative federal appeals court in the country. But, 'O'Connor is so far off the reservation here that virtually any (appeals) panel will reverse him,” Jost said.

Congressional Republicans, however, were quick to offer praise for the ruling. House Republican Leader Kevin McCarthy said in a statement that 'Obamacare is a broken law … Yesterday's court decision also underscores what we have believed - it is an unconstitutional law.”

Democrats including Senate leader Chuck Schumer said the decision should not stand.

'This outrageous ruling threatens health coverage for millions of Americans … This ruling must be overturned,” said Democratic Senator Debbie Stabenow of Michigan in a statement.

The Reuters and Bloomberg news services contributed to this report.