A federal appeals court on Wednesday struck down a central provision of the Affordable Care Act, ruling that the requirement that people have health insurance was unconstitutional.
But the appeals panel did not invalidate the rest of the law, instead sending the case back to a federal district judge in Texas to “conduct a more searching inquiry” into which of the law’s many parts could survive without the mandate.
The 2-1 decision, by a panel of the United States Court of Appeals for the Fifth Circuit in New Orleans, left the fate of the nearly decade-old health law in limbo even as access to health care has become a central issue in the presidential race.
Republicans, for whom a decision to throw out the law heading into the presidential election year could have been a political nightmare, seemed relieved, while Democrats issued a flurry of statements emphasizing that the law was still in grave danger.
The ruling was issued almost exactly a year after Judge Reed O’Connor of the Federal District Court in Fort Worth struck down the entire law, saying the individual mandate could not be severed from the rest of the Affordable Care Act because it was “the keystone” of the law, essential to its regulation of the health insurance market. With Judge O’Connor now facing a time-consuming assignment from the appellate court, the case is unlikely to be resolved before next year’s presidential election.
But Xavier Becerra, the California attorney general who led 21 states that intervened in the case and argued to preserve the law, made clear that he planned to challenge the appeals court decision by petitioning the Supreme Court to take the case.
“For now, the president got the gift he wanted — uncertainty in the health care market and a pathway to repeal,” Mr. Becerra said in a call with reporters on Wednesday night.
In a statement that showed just how consequential the issue is for him, President Trump tried to appeal both to opponents of the law and voters concerned about losing their health care. He described the ruling as “a big win for all Americans,” but said it would not alter the health care system. Mr. Trump also said he wanted to protect people with pre-existing conditions, as the Affordable Care Act that he has repeatedly sought to kill does.
“Providing affordable, high-quality health care will always be my priority,” he said.
Two of the three appellate judges, Jennifer Walker Elrod, appointed by President George W. Bush in 2007, and Kurt Engelhardt, appointed by President Trump in 2018, joined the ruling. The third, Carolyn Dineen King, appointed by President Jimmy Carter in 1979, dissented.
Some 17 million Americans could lose the coverage gained through the Affordable Care Act if the law were thrown out, more than 50 million people with pre-existing medical conditions could again be denied health insurance and insurers would no longer have to cover people up to age 26 under their parents’ plans.