The stakes ramped up again this week, when President Donald Trump’s Justice Department announced it had changed its position and agreed with the judge that the entire law, not just three pieces of it, should be scrapped.
If the appeals court accepts the Trump administration’s new arguments, millions of people could lose health insurance, including those who gained coverage through the expansion of Medicaid and those who have private coverage subsidized by the federal government.
US District Judge Reed O'Connor in Fort Worth agreed with a coalition of 20 states that a change in tax law last year eliminating a penalty for not having health insurance invalidated the entire Obamacare law.
About $10 billion is at stake through a premium stabilization program. Insurers with healthier-than-average customers pay into the program, and the money goes to insurers with sicker patients. No taxpayer subsidies are involved.