Texas Federal District Judge Reed O’Connor, who a few years ago struck down the Obama-era “one-bathroom-fits-all” rule for public schools, has this day ruled that the Affordable Care Act (ACA, or Obamacare) is unconstitutional. Immediate appeals are expected, and the White House has signaled that the law will remain in effect, while at the same time voicing support for the decision.

judge-rules-obamacare-unconstituionalThe ruling arrives one day before open enrollment for 2019 is to end.

President Trump immediately tweeted that Congress must now pass “a STRONG law that provides GREAT healthcare … Mitch and Nancy, get it done!”

The ruling comes after the judge heard arguments over a lawsuit in September brought by Texas Attorney General Ken Paxton, who was joined by 17 other state attorneys general and two governors. Blue State attorneys general argued against the Paxton coalition.

The Red State argument hinged on the fact that the health care law survived a Supreme Court review only because Chief Justice John Roberts, in a surprise, last-minute decision, ruled Obamacare legal because the individual mandate was a “tax.” In 2017, however, Republicans in Congress took away the tax part of the mandate, giving the challengers an opportunity to argue that the law was no longer constitutional.

Judge O’Connor agreed. “The Individual Mandate can no longer be fairly read as an exercise of Congress’s Tax Power and is still impermissible under the Interstate Commerce Clause — meaning the Individual Mandate is unconstitutional,” O’Connor wrote. “The Individual Mandate is essential to and inseverable from the remainder of the ACA.”

Some 17 million Obamacare policyholders could be in jeopardy, and in addition, the pre-existing conditions clause and the essential health benefits clause of the ACA could be in jeopardy for anyone covered under an employment or other health insurance plan.

The ruling, which does not include an injunction, would have to be appealed through the 5th U.S. Circuit Court of Appeals in New Orleans, arguably the nation’s most conservative appeals board. Most likely, the Supreme Court will once again have to rule on the issue, a process that could take a couple of years.

Shortly after the ruling was made public, the Department of Health and Human Services (HHS), which oversees the ACA, issued this statement:

The recent U.S. District Court decision regarding the Affordable Care Act is not an injunction that halts the enforcement of the law and not a final judgment. Therefore, HHS will continue administering and enforcing all aspects of the ACA as it had before the court issued its decision. This decision does not require that HHS make any changes to any of the ACA programs it administers or its enforcement of any portion of the ACA at this time. As always, the Trump Administration stands ready to work with Congress on policy solutions that will deliver more insurance choices, better healthcare, and lower costs while continuing to protect individuals with pre-existing conditions.