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NEW ORLEANS - A federal appeals court panel grilled Democratic attorneys general Tuesday about whether Obamacare violates the Constitution as it weighs whether to uphold a Texas judge's ruling striking down the landmark health care law.
The judges focused on whether the 2010 Affordable Care Act lost its justification after Republican President Donald Trump in 2017 signed a law eliminating a tax penalty used to enforce the mandate that Americans buy health insurance coverage.
Republicans have repeatedly tried and failed to repeal Obamacare since its 2010 passage. The Justice Department normally would defend a federal law, but the Trump administration declined to go against the challenge made by 18 Republican-led states.
'If you no longer have a tax, why isn't it unconstitutional?” Judge Jennifer Elrod, who was appointed to the 5th Circuit Court of Appeals by Republican President George W. Bush, asked attorneys for the Democratic officials defending the law during a hearing.
A coalition of Democratic state attorneys general led by California's Xavier Becerra stepped up to defend the law. The U.S. House also intervened after Democrats won control in November's elections during which many focused their campaigns on defending Obamacare.
Democrats held news conferences and protests Tuesday in support of Obamacare, including in Des Moines and Cedar Rapids - two of the cities where voters flipped House seats from Republican to Democrat in the 2018 midterm elections.
About 30 people gathered in front of the U.S. Northern District Court of Iowa in Cedar Rapids, an event organizers said was part of an effort to raise awareness on the implications a repeal could have on Iowans.
According to preliminary figures released by federal officials this past December, more than 49,000 Iowans enrolled in insurance plans for 2019 - which was down about 7 percent from 2018.
The three-judge panel in New Orleans is not expected to decide until later whether to overturn or uphold a ruling last year by a federal judge in Texas that the entire health care law was unconstitutional.
An appellate ruling declaring Obamacare unconstitutional could prompt an appeal to the U.S. Supreme Court, opening the door for the top court to take up the issue in the midst of the presidential election.
Obamacare, the signature domestic achievement of Trump's Democratic predecessor, Barack Obama, has been a political flashpoint since its passage.
Republican opponents call the law an unwarranted intervention by government, while supporters say striking it down would threaten the health care of 20 million people who have gained insurance under the law.
In 2012, a divided U.S. Supreme Court upheld most of its provisions, including the individual mandate, which requires people to obtain insurance or pay a penalty.
The mandate compelled healthy people to buy insurance to offset sicker patients' costs after Obamacare barred insurers from denying coverage to people with preexisting conditions.
The Supreme Court's conservative majority argued that Congress could not constitutionally order people to buy insurance. But Chief Justice John Roberts joined the court's four liberal members to hold the mandate was a valid exercise of Congress' tax power.
But after Trump signed a tax bill that reduced the penalty to zero, a coalition of GOP-led states sued, alleging the penalty's elimination rendered Obamacare unconstitutional.
Michaela Ramm of The Gazette contributed to this report.