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Former President Barack Obama's signature policy initiative, the Affordable Care Act, was ruled unconstitutional by a federal judge in Texas on Friday, but the ruling won't change the health-care coverage for millions of Americans — at least not right now and maybe not ever.
The U.S. Department of Health and Human Services said it will continue enforcing "all aspects of the ACA."
The ruling by U.S. District Court Judge Reed O'Connor of Texas doesn't block the ACA, for now, and will likely be appealed to a higher court.
California Attorney General Xavier Becerra, who led a group of 16 Democratic state attorneys general defending the ACA, said Friday they intend to challenge the ruling in the U.S. Court of Appeals for the Fifth Circuit in New Orleans. The process could take several months, and the decision could potentially go all the way to the Supreme Court.
"The most important thing is nothing changes for consumers," in the short term, said Andy Slavitt, a former administrator for the Centers for Medicare & Medicaid Services under the Obama administration. "This (case) is to going to go on and likely drag on for a couple of years."
O'Connor declared Friday that key portions of the ACA, more commonly known as Obamacare, were inconsistent with the U.S. Constitution. O'Connor's ruling argued that the health-care law cannot stand on its own since Congress last December repealed the so-called individual mandate, which imposed a tax penalty on consumers without coverage.
The mandate, which remains in effect for 2018, was a key part of the ACA legislation. It was designed to persuade people to buy insurance instead of paying the extra tax, which came to the greater of $695 per adult or up to 2.5 percent of household income, depending on how many months an individual went without coverage.
President Donald Trump immediately praised the ruling on Twitter, saying that "Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions."
The Trump administration supported a coalition of about 20 Republican state attorneys general and governors in arguing against the health-care law. But the states went further than the federal government in how much of the law they believed had to go.
The states argued that if the court struck down the individual mandate, the entire law must be declared unconstitutional. In contrast, the Trump administration took a softer approach, suggesting that the bulk of the colossal piece of legislation was "severable," or able to stand even if the individual mandate provisions were struck. It argued against the states' demand for an injunction, which could have created more uncertainty about the immediate fate of the law's provisions.
The Trump administration also asked the court to defer any ruling until after the close of the open enrollment period to "ensure that there is no disruption."
The five justices who voted to uphold the constitutionality of the law in 2012 are still on the Supreme Court, but debates over the ruling linger. While the court maintained the law, it struck down the government's argument defending Obamacare based on the federal government's authority to regulate interstate commerce. Instead, in a ruling that took the legal community by surprise, chief justice John Roberts wrote that the individual mandate was permissible as a tax.
Several Wall Street analysts and health policy researchers said Monday they expect the Friday ruling to be overturned should it get to the Supreme Court, citing the decision that upheld Obamacare in a narrowly divided 2012 ruling. Should the law be struck down, Congress would have to come up with a replacement.
The ruling on Friday came hours before the ACA's last day to enroll in a health plan for next year. Shortly after the decision, Medicare chief Seema Verma said in a tweet that ACA exchanges were still open for business and the agency will continue with open enrollment, which ended Saturday in most states.
"There is no impact to current coverage or coverage in a 2019 plan," Verma said. "The recent federal court decision is still moving through the courts."
Obama also took to social media, warning consumers not be scared away by headlines of the health law being struck down.
"It's so important for you to know that last night's ruling changes nothing for now," Obama said in a Facebook post. "As this decision makes its way through the courts, which will take months, if not years, the law remains in place and will likely stay that way."