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Appeals court hears case that would strike down Obamacare

MIAMI, FLORIDA - JUNE 27: Democratic presidential candidates former Vice President Joe Biden (L) and Sen. Bernie Sanders (I-VT) take part in the second night of the first Democratic presidential debate on June 27, 2019 in Miami, Florida.  A field of 20 Democratic presidential candidates was split into two groups of 10 for the first debate of the 2020 election, taking place over two nights at Knight Concert Hall of the Adrienne Arsht Center for the Performing Arts of Miami-Dade County, hosted by NBC News, MSNBC, and Telemundo. (Photo by Drew Angerer/Getty Images)
Biden defends Obamacare as rivals seek to replace it
2:28 • Source: CNN
MIAMI, FLORIDA - JUNE 27: Democratic presidential candidates former Vice President Joe Biden (L) and Sen. Bernie Sanders (I-VT) take part in the second night of the first Democratic presidential debate on June 27, 2019 in Miami, Florida.  A field of 20 Democratic presidential candidates was split into two groups of 10 for the first debate of the 2020 election, taking place over two nights at Knight Concert Hall of the Adrienne Arsht Center for the Performing Arts of Miami-Dade County, hosted by NBC News, MSNBC, and Telemundo. (Photo by Drew Angerer/Getty Images)
2:28

What you need to know

  • Arguments heard: An appeals court in New Orleans heard a case that would strike down the Affordable Care Act, also known as Obamacare.
  • About the case: It was initiated by Texas and other Republican-led states, and has since been joined by the Department of Justice. Last year, a federal judge in Texas struck down the health care law. Today’s hearing is the appeal of that case.
  • Remember: The court is not expected to issue a ruling on the case today.
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An appeals court is considering the fate of Obamacare. Here's what you need to know.

An appeals court in New Orleans heard a case this afternoon that would strike down the Affordable Care Act, also known as Obamacare.

Our live coverage is wrapping up, but here’s what you need to know about the hearing — and what happens next.

  • The big takeaway: During the hearing, two Republican-appointed judges on the appeals panel today suggested that they might side with a lower court judge who said last year that the whole Obamacare law should be struck down.
  • About the judges: It’s a panel of three judges — two Republican-appointed and one Democrat-appointed — meaning two of the judges will control the ruling.
  • The two sides: Lawyers from the Trump administration and a group of Republican states squared off against attorneys from a coalition of Democratic states and the House of Representatives.
  • This is the appeal of a case out of Texas: Last year, US District Court Judge Reed O’Connor sided with a group of Republican-led states that sought to declare the ACA unconstitutional
  • So what happens next? The judges did not issue a ruling, so a decision is still pending. It’s important to note that while the Texas judge’s decision last year struck down Obamacare, that ruling was put on hold pending the appeal — so the ACA is still in place.

Judges press Justice Department attorney on fate of the ACA

Judge Jennifer Elrod, a George W. Bush appointee, and Judge Kurt Engelhardt, a Donald Trump appointee, pressed a Department of Justice attorney about what would happen if the courts found that the law was unconstitutional.

Justice Department Attorney August Flentje said the administration is “appreciative” that the district court judge put his ruling on hold, stressing that if the Affordable Care Act falls, a lot must be sorted out.

The judges questioned whether Obamacare could be invalidated only in the 18 states that brought the lawsuit, while remaining valid in the rest of the country.

Douglas Letter, arguing for the now-Democratic controlled House of Representatives, later jumped on Flentje’s ambiguous responses, saying that the Justice Department’s position makes no sense. It would be impossible to divide up certain provisions by state, pointing out one that makes it easier to bring to market lower-cost versions of certain complex drugs.

The attorney for the House also stressed that he did not want the case to be sent back to the district court, saying that at a minimum the appellate court judges could strike down the individual mandate but uphold the rest of the law.

California Attorney General's office: "We will fight the administration tooth and nail"

The California Attorney General’s office says it is prepared to fight to defend the Affordable Care Act.

Attorney General Xavier Becerra is leading a coalition of 20 states and Washington, D.C. to advocate for the bill to stay.

“Today we saw an administration pressed to explain why affordable health care and American lives should be put at risk,” Lovenheim said.

She continued that if the ACA was removed, it would create chaos in the health care system.

“If they have their way millions of Americans could be forced to delay, skip or forgo potentially lifesaving health care all together,” she said.

Here's what Texas' solicitor general said about the ACA in court today

Lawyers from the Trump administration and a group of Republican states squared off today against attorneys from a coalition of Democratic states and the House of Representatives in a New Orleans appeals court to argue the fate of the Affordable Care Act.

Texas Solicitor General Kyle Hawkins argued in court that the ACA forces people to buy insurance or pay a penalty.

“The Affordable Care Act has what amounts to an inseverability clause because the penalty is essential to drive people to buy insurance,” Hawkins said.

The plain text of the 2010 law, he said, is a “commandment to the American people.”

Hawkins would not be able to say what Congress intended when it acted in 2017 to axe the individual mandate, however.

Hawkins went on to say that “what happened in 2017 … is that Congress took away” the part of Chief Justice John Roberts’ opinion calling it a tax. Because of what Congress did, Roberts’ base holding that the law is OK because it’s a tax, is now “irrelevant,” he said.

Texas attorney general: Trump's tax overhaul "rendered Obamacare unconstitutional"

Texas Attorney General Kenneth Paxton (2nd R) speaks to members of the media as former Texas Solicitor General Scott Keller (R) listens in front of the US Supreme Court April 18, 2016 in Washington, DC

The Texas Attorney General’s office put out a statement following today’s hearing:

In court today, lawyers from the Trump administration and a group of Republican states squared off against attorneys from a coalition of Democratic states and the House of Representatives. The Republican coalition was led by Paxton.

There is one Dem-appointed judge on the panel. She did not ask questions.

Judge Carolyn Dineen King, an appointee of President Jimmy Carter, asked no questions during today’s hearing.

The questions came from the two GOP appointees: Judge Jennifer Elrod, a George W. Bush appointee, and Judge Kurt Engelhardt, a Donald Trump appointee.

Engelhardt also suggested the overall issue is a question best left for Congress and the White House.

“There is a political solution here” that the parties want the courts to solve, he said. The courts should not be a “taxidermist” for ever big-ticket law Congress passes, Engelhardt added.

Without mentioning the political aspects that the House is now controlled by Democrats and the Senate remains under the GOP, he pressed the issue of the Senate not being in the courtroom.

Republican-appointed judges suggested they could side with lower court that struck down Obamacare

Two Republican-appointed judges on the appeals panel today suggested that they might side with a lower court judge who said last year that the whole Obamacare law should be struck down.

Keep in mind: This is a three-judge panel, meaning two of the judges will control the ruling.

About the two sides: Lawyers from the Trump administration and a group of Republican states squared off against attorneys from a coalition of Democratic states and the House of Representatives.

And about the judges: Three 5th US Circuit Court of Appeals judges — one nominated by President Donald Trump, one by George W. Bush and one by Jimmy Carter — heard the arguments. Because the case is before one of the most conservative appellate courts in the country, it is almost guaranteed to wind up in the Supreme Court.

Attorney for Democratic-led House argues Texas and other states are exaggerating the impact of the law

Douglas Letter, arguing for the now-Democratic controlled House of Representatives, said that Texas and other states are exaggerating the impact of the law President Trump signed in 2017 eliminating the mandate.

Texas, he said, created a new excuse to challenge a law it doesn’t like that was upheld in 2012.

“Texas said, ‘Ha! — you just did something unconstitutional,’” Letter said.

Even though the tax penalty is now zero dollars, Letter argued, the choice people has still exists: buy insurance or don’t.

“The Supreme Court said unequivocally. …Either you shall maintain health insurance or incur a tax,” he said. Only the number has changed.

“That means the choice is still there,” he said. In fact, “there’s less coercion than there was before” to buy insurance.

Judge suggest eliminating individual penalty jeopardized basis for entire law

Speaking about the Affordable Care Act, Judge Kurt Engelhardt, a President Trump appointee, asked, “If you no longer have the tax, why is it still constitutional?”

He noted that Congress could have included a severability clause to ensure that while the individual mandate was eliminated, it wanted the rest of the law to remain.

“Instead, they did the opposite, he said. 

Samuel Siegel, California’s deputy solicitor general, said that in fact, because Congress only acted on the mandate, it didn’t want the rest to be touched.

“The entire Affordable Care Act can cooperate without the individual mandate,” he said, noting that some lawmakers were clear they only wanted to act on the tax. Congress, he noted, failed in other attempts to kill the entire bill. 

Siegel did not mention the Senate vote where the late Arizona Republican Sen. John McCain cast the deciding vote to end the bill to repeal most of Obamacare, but Trump has consistently mentioned that as he promotes ongoing efforts to gut the law.

The hearing just wrapped up

An appeals court in New Orleans has been hearing a case that would strike down the Affordable Care Act, also known as Obamacare.

The hearing just wrapped up.

The two Republican-appointed judges on the three-judge panel strongly suggested that Congress, by eliminating the individual penalty for not having health insurance under the law, had jeopardized the basis for the entire law under the Supreme Court’s 2012 ruling. 

Remember: While the judges heard from both sides today, the court is not expected to issue a ruling on the case.

A Texas judge struck down the Affordable Care Act — but the law is still in place. Here's why.

An appeals court in New Orleans this afternoon will hear a case that would strike down the Affordable Care Act, also known as Obamacare.

It’s the appeal of a case out of Texas: Last year, US District Court Judge Reed O’Connor sided with a group of Republican-led states that sought to declare the ACA unconstitutional

But the ACA is still in place: While the judge’s decision struck down Obamacare, that ruling was put on hold pending today’s appeal.

That means the ACA — which allows millions of people to get health insurance through exchanges or Medicaid expansion, saves senior citizens money on their Medicare coverage and prescription drugs and allows children to stay on their parents’ health insurance plans until they turn 26, among other provisions — is still in effect today.

A look at the history of the Affordable Care Act

The Affordable Care Act is considered President Barack Obama’s signature achievement.

But, the ACA, often referred to as “Obamacare,” has been met with opposition and could eventually find itself before the Supreme Court.

In the newest attempt to roll back the ACA, a Texas appeals court will hear arguments today that could ultimately strike down the act. Courts have previously upheld Obamacare, but this will be the first hearing since Congress got rid of the tax penalty for not having insurance.

Here’s a look at the history of Obamacare:

  • The Affordable Care Act was signed into law in 2010 and came into full effect in 2014.
  • Its main goal was to make healthcare affordable and reduce the number of Americans who are uninsured. It also promised to expand coverage and treatment options.
  • In 2013, 42 million Americans did not have health insurance. That number dropped to 29 million in 2015.
  • Republicans opposed the act and made many attempts to get rid of it. In fact, in 2016, one of President Trump’s campaign promises was to repeal Obamacare.
  • Once Trump took office, Republicans were not able to get enough votes in Congress to roll Obamacare back.
  • But even though Republicans in Congress fell short of votes, they did make other moves to chip away at it. The tax cut bill in 2017 included a provision that eliminated the individual mandate that compelled people to get health insurance.

Watch more:

Here's why healthcare is so expensive in the United States

The United States spends more on healthcare than any other country in the world. In the 2018 fiscal year, that number was about $1.1 trillion, according to the Tax Policy Center.

CNN Chief Medical Correspondent Dr. Sanjay Gupta says there are several things that could be contributing to the rising healthcare costs in America. They are…

  • Drug prices: The price of prescriptions are set by the company that makes them. Unlike other countries, individual consumers can’t negotiate for lower rates — only the Department of Veterans Affairs and Medicaid have the power to do that.
  • Administrative costs: Because the billing process is so complicated, there are a lot of people who work to figure out how to charge you for an appointment or procedure. These administrators deal with things like co-pays, co-insurance and deductibles. This gets complicated because it’s not a one-size-fits-all model. For example, some people may get prescribed treatments that are more expensive or have to go to specialists.
  • Defensive medicine: This is when doctors may order more tests than they need in order to avoid a lawsuit. Even if they are confident in a diagnosis, some doctors feel the need to create a paper trail to show that everything else has been ruled out in case they get taken to court.

Learn more:

Chuck Schumer: "Donald Trump and the Republicans want to take away your health care"

Carrying photographs of Americans with pre-existing medical conditions, Senate Minority Leader Chuck Schumer and Speaker of the House Nancy Pelosi hold a photograph of Emilie Saltzman as they lead a group of Democratic members of Congress down the steps of the US Capitol to a news conference July 9, 2019 in Washington, DC.

Senate Majority Leader Chuck Schumer and Speaker of the House Nancy Pelosi emphasized the Democratic party’s commitment to the Affordable Care Act (ACA) at a news conference today.

Schumer and Pelosi were joined by Senate and House Democrats, each holding a poster depicting the face of an American affected by a pre-existing condition.

“Today, House and Senate Democrats are here to show the human stakes of the GOP’s relentless assault on health care,” Pelosi said. “Every family in America is one phone call, one diagnosis, one accident away from being slaves to pre-existing conditions and the costs that they incur, and, more importantly, the toll they take on the health of family members.”

She added: “It’s really important that the court honor its precedent and it ruled in favor of the Affordable Care Act on a previous occasion.”

Two groups of states are battling in court today over Obamacare

An appeals court in New Orleans is considering a case that would strike down the Affordable Care Act, also known as Obamacare.

The three-judge appeals court panel will hear arguments from both sides starting at 2 p.m. ET.

About the anti-ACA side: The case was initiated by Texas and other Republican-led states, and has since been joined by the Department of Justice. Last year, a federal judge in Texas sided with those that want to get rid of the ACA, and struck down the health care law. Today’s hearing is the appeal of that case.

About the pro-ACA side: Defenders of the ACA, which include California and other Democratic-run states, as well as the House of Representatives, argue that if lawmakers want to repeal ACA regulations, they would have done so in their 2017 actions against it (which reduced the tax penalty for those who lacked insurance to zero).

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