Tonight, hand-picked, conservative, right-wing federal District Court Judge Reed O’Connor ruled the entire Affordable Care Act unconstitutional. His decision would end protections for people with pre-existing conditions, re-institute lifetime limits on coverage, implement an age tax on older Americans, end Medicaid expansion, and take away coverage from tens of millions of Americans. In short, an absolute disaster for Americans and their health care.

His decision would cause irreparable harm to the nation’s health care system:

New York Times: 17 Million Americans Would Lose Their Health Insurance. “If Judge O’Connor’s decision ultimately stands, about 17 million Americans will lose their health insurance, according to the Urban Institute, a left-leaning think tank. That includes millions who gained coverage through the law’s expansion of Medicaid, and millions more who receive subsidized private insurance through the law’s online marketplaces” [New York Times, 12/14/18]

Vox: Americans Could Once Again Be Denied Coverage For Pre-Existing Conditions. “Usually, a presidential administration defends current law, but the Trump administration took a different approach in this case. It agreed with the conservative states that the mandate and, with it, the law’s rules that prohibits insurers from denying people health insurance or charging them higher rates, should be found unconstitutional…. If the Trump administration’s argument were to prevail, insurers could once again be able to flat-out deny Americans insurance based on their health status. No amount of federal subsidies would protect them. Medicaid expansion would remain, but the private insurance market would no longer guarantee coverage to every American.” [Vox, 12/14/18]

Texas Tribune: Ruling “Could Throw The Nation’s Health Care System Into Chaos.” “In a ruling that could throw the nation’s health care system into chaos, Fort Worth-based U.S. District Judge Reed O’Connor on Friday ruled that a major provision of the Affordable Care Act is unconstitutional — and that the rest of the landmark law must fall as well…Legal scholars — even some conservatives who oppose the law — have nonetheless called Texas’ argument unconvincing.” [Texas Tribune, 12/14/18]

Larry Levitt, Kaiser Family Foundation: “If Upheld, This Would Throw Out Not Only The law’s Pre-Existing Condition Protections, But Also Everything Else.” “If upheld, this would throw out not only the law’s pre-existing condition protections, but also everything else — premium subsidies, expanded Medicaid, preventive services, and much more.” [Larry Levitt Twitter, 12/14/18]

His decision came following midterm elections in which health care carried Democrats to elected office across the country:

Politico: Decision Comes After Midterm Elections Which Partially Served “As A Rebuke To Republican Efforts To Tear Down Obamacare.” “The invalidation of the landmark 2010 law is certain to send shock waves through the U.S. health system and Washington after a midterm election seen in part as a rebuke to Republican efforts to tear down Obamacare.” [Politico, 12/14/18]

CNN: “Protecting Those With Pre-Existing Conditions Became A Central Focus Of [Midterm] Races.” “The lawsuit entered the spotlight during the midterm elections, helping propel many Democratic candidates to victory. Protecting those with pre-existing conditions became a central focus of the races. Some 58% of Americans said they trust Democrats more to continue the law’s provisions, compared to 26% who chose Republicans, according to a Kaiser Family Foundation election tracking poll released in mid-October.” [CNN, 12/14/18]

His decision came as open enrollment wraps up, underscoring the GOP’s obsession with sabotaging America’s health care system:

Bloomberg: Decision “Underscores A Divide Between Republicans Who Have Long Sought To Invalidate The Law And Democrats Who Fought To Keep It In Place.” “The decision Friday finding the Affordable Care Act unconstitutional comes just before the end of a six-week open enrollment period for the program in 2019 and underscores a divide between Republicans who have long sought to invalidate the law and Democrats who fought to keep it in place.” [Bloomberg, 12/14/18]

Washington Examiner: The Decision Came The Day Before The End Of Open Enrollment, Cementing the Trump Administration’s Sabotage Of The Marketplace. “The decision came just a day ahead of when the open enrollment for Obamacare’s marketplaces are set to close across most of the U.S. Enrollment in these marketplaces has been lagging, with some critics arguing that the zeroing out of the fine is partially to blame.” [12/14/18]

Axios: “Republicans Have Never Come Up With A Replacement Plan That Would Offer The Same Level Of Protection As The ACA.” “In an interview with “Axios on HBO,” President Trump said he’d reinstate protections for pre-existing conditions if the lawsuit gutted the ACA. But as Axios’ Sam Baker notes, Republicans have never come up with a replacement plan that would offer the same level of protection as the ACA.” [Axios, 12/14/18]

And his decision was written on questionable legal grounds:

The Hill: “Legal Experts In Both Parties Have Denounced [The Judge’s] Argument.” “In a controversial move, the judge added that because the mandate is ‘essential’ to the rest of the law, without the mandate, the entire law is invalid. Legal experts in both parties have denounced that argument, saying it is obvious that Congress wanted the rest of the Affordable Care Act to remain when it repealed only the mandate penalty last year.” [The Hill, 12/14/18]

Washington Post: “Many Health-Law Specialists Have Viewed Its Logic As Weak.” “A federal judge in Texas threw a dagger on Friday into the Affordable Care Act, ruling that the entire health-care law is unconstitutional because of a recent change in federal tax law….Since the suit was filed in January, many health-law specialists have viewed its logic as weak but nevertheless have regarded the case as the greatest looming legal threat to the 2010 law, which has been a GOP whipping post ever since and assailed repeatedly in the courts.” [Washington Post, 12/14/18]

Jonathan Cohn, HuffPost: “This Is A Breathtaking Ruling In Favor Of A Lawsuit That Even Conservative Legal Experts Have Trashed.” [Jonathan Cohn Twitter, 12/14/18]

Paul McLeod, Buzzfeed: When It Comes To Judicial Activism, “You Can’t Come Up With A Clearer Example Than This.” “Can’t stress enough that when we hear about ‘judicial activism’ you can’t come up with a clearer example than this. This judge overturned the will of Congress (technical details of why/how are in the story.) But legal experts I talked to described this interpretation as ludicrous.” [Paul McLeod Twitter, 12/14/18]

Experts were incredulous:

Nicholas Bagley, University Of Michigan Health Law Professor: “This Is Insanity In Print.” “The court’s decision is NOT limited to guaranteed issue and community rating. In the court’s view — and this is *absolutely* insane — the entire Affordable Care Act is unconstitutional…If you were ever tempted to think that right-wing judges weren’t activist — that they were only “enforcing the Constitution” or “reading the statute” — this will persuade you to knock it off. This is insanity in print, and it will not stand up on appeal.” [Nicholas Bagley Twitter, 12/14/18]

Timothy Jost, Washington And Lee University Law Professor: “It’s Timed To Cause Maximum Chaos.” “This is breathtaking in its sweep & I think O’Connor has no idea what he’s doing..This is going to get thrown out. But I also think it’s timed to cause maximum chaos.” [Emma Platoff, Texas Tribune Reporter, 12/14/18]

And here’s what elected officials said:

Speaker-Designate Nancy Pelosi (D-CA): “Tonight’s District Court Ruling Exposes The Monstrous Endgame Of Republicans’ All-out Assault On People With Pre-existing Conditions.” “Tonight’s district court ruling exposes the monstrous endgame of Republicans’ all-out assault on people with pre-existing conditions and Americans’ access to affordable health care. The GOP Congress tried and failed to destroy the Affordable Care Act and protections for pre-existing conditions.  Then, in the midterm election, the American people delivered a record-breaking margin of almost 10 million votes against House Republicans’ vile assault on health care. Now, the district court ruling in Republicans’ lawsuit seeks to subvert the will of the American people and sow chaos in the final day of HealthCare.gov open enrollment.” [Office Of The Speaker-Designate, 12/14/18]

House Ways & Means Ranking Member Richard Neal (D-MA), Energy and Commerce Ranking Member Frank Pallone, Jr. (D-NJ), and Education and the Workforce Committee Ranking Member Bobby Scott (D-VA): “It Is An Ideological Decision In A Case That Has No Legal Merit.” “This reckless court decision endangers the lives of millions of Americans who are going to lose their health care. It is an ideological decision in a case that has no legal merit.  Last month’s election results showed how important access to health coverage and protections for pre-existing conditions are for American families, and we are calling for an emergency stay of this heartless ruling. We will take immediate action in the new Congress to intervene in this case and appeal this decision. House Democrats will do whatever it takes to make sure the protections enshrined in the Affordable Care Act endure. The lives and wellbeing of millions of Americans – including those living with pre-existing conditions – are on the line.” [Ways and Means Democrats, 12/14/18]

Senate Minority Leader Chuck Schumer (D-NY): “If This Awful Ruling Is Upheld In The Higher Courts, It Will Be A Disaster For Tens Of Millions Of American Families.” “If this awful ruling is upheld in the higher courts, it will be a disaster for tens of millions of American families, especially for people with pre-existing conditions. The ruling seems to be based on faulty legal reasoning and hopefully it will be overturned. Americans who care about working families must do all they can to prevent this district court ruling from becoming law.” [Sen. Chuck Schumer Twitter, 12/14/18]

Sen. Chris Murphy (D-CT): “This Is A Five Fire Alarm — Republicans Just Blew Up Our Health Care System.” “This is a five alarm fire — Republicans just blew up our health care system. The anti-health care zealots in the Republican Party are intentionally ripping health care away from the working poor, increasing costs on seniors, and making insurance harder to afford for people with preexisting conditions…Don’t be fooled, this rests one hundred percent on the shoulders of President Trump and Republicans in Congress who empower him. Trump took the extraordinary step of sending his lawyers to argue to end health coverage for 20 million people and he got his wish. Not a single Senate Republican challenged him, and now they own this disaster as much as he does.” [Sen. Chris Murphy, 12/14/18]

Senate Finance Committee Ranking Member Ron Wyden (D-OR): “A Deliberate, Ideological Move To Sabotage The Affordable Care Act At The Expense Of Families’ Health Care.” “Today’s ruling is an assault on all Americans’ basic health care rights and judicial overreach at its worst. Trump and Republicans in Congress will achieve their long-sought goals if this ruling stands: the elimination of pre-existing condition protections and Medicaid coverage for millions of vulnerable Americans. Seniors will pay more for their prescriptions and middle-class families will lose tax breaks that keep their health care affordable. This judge chose to deliver his ruling the day before the end of open enrollment – a deliberate, ideological move to sabotage the Affordable Care Act at the expense of families’ health care.” [Sen. Ron Wyden, 12/14/18]