The circuitous effort by Republicans to repeal the Obama health law takes another step forward on Tuesday before the Fifth Circuit Court of Appeals in New Orleans, as a three judge panel will consider a lower court ruling which found that the end of the tax penalty for not buying health insurance should bring down the entire Obamacare health system.
Supporters of the Obama health law have argued for months that a legal victory would be catastrophic for the U.S. health care system.
"The entire ACA is at risk," said Xavier Becerra, the state Attorney General of California.
"This has huge implications for people, and also the election," said Larry Levitt, an opponent of the lawsuit, and a top official with the Kaiser Family Foundation, who argues that "tens of millions of people would lose health coverage or insurance protections immediately."
"That could instantly become the overriding issue in the campaign," Levitt tweeted on Monday.
The three judges who will hear the appeal are Kurt Engelhardt, who was put on the bench by President Donald Trump; Jennifer Elrod, nominated by President George W. Bush; and, Carolyn King, put on the federal bench by President Jimmy Carter.
On the other side, Republicans see it much differently, making the case that with the individual mandate penalty to buy health insurance now at zero - the entire Obama health law should fall as well.
"Congress meant for the individual mandate to be the centerpiece of Obamacare," argued Texas state Attorney General Ken Paxton, who has led the charge against the law. "Without the constitutional justification for the centerpiece, the law must go down."
18 states are pressing the case to uproot what's officially known as the Affordable Care Act: Texas, Alabama, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nebraska, North Dakota, South Carolina, South Dakota, Tennessee, Utah, West Virginia, and Arkansas.
"The district court correctly held that the individual mandate is unconstitutional in light of the elimination of its penalty," the GOP states argue, asking then for the entire law to be tossed out.
The GOP is not fully united on this lawsuit, as the Republican Attorney General of Ohio and Montana have submitted formal legal arguments against using this case to overturn the Obama health law.
"The court’s decision, if affirmed, will deprive millions of non-elderly Ohioans and Montanans of coverage for pre-existing conditions," the AG's argued. "It will also negatively affect countless others who organized their affairs in reliance on the Act’s many unrelated provisions."
No matter how the Fifth Circuit panel ultimately rules on these arguments, this could be a case which ends up before the U.S. Supreme Court.
One thing which should still be noted - is that while Republicans want to do away with the current health care system - GOP lawmakers in Congress still haven't agreed on how to replace the Obama health law.
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