States Ask Judge to Declare Health Law Still in Effect While Ruling Is Appealed

California and 15 other states asked a federal judge on Monday to protect current health care coverage for millions of Americans while courts sort out the implications of his ruling that the Affordable Care Act was invalid in its entirety.

The states, which support the health care law, said the ruling on Friday, by Judge Reed O’Connor of the Federal District Court in Fort Worth, had caused immense confusion about whether the law was still in effect, and whether consumers were still entitled to its benefits and protections.

The states asked Judge O’Connor to clarify whether he meant his decision to have “any immediate legal effect.”

In his sweeping decision, Judge O’Connor held that a provision at the heart of the Affordable Care Act — a requirement for most Americans to have health insurance known as the individual mandate — was unconstitutional and that other provisions of the law could not survive because they were inextricably linked to the coverage mandate. The sprawling law includes not only health insurance exchanges and an expansion of Medicaid, but also protections for people with pre-existing conditions, requirements for what insurance must cover and much more.

But Judge O’Connor did not issue an injunction barring enforcement of the law.

“In light of this ambiguity,” California and the other states asked Judge O’Connor on Monday to affirm that the Affordable Care Act was still the law and should be enforced while supporters and opponents of the measure continue their battle in court.

“The district court’s ruling poses a dangerous threat to the health care of millions of Americans,” said the California attorney general, Xavier Becerra. “Today’s filing makes clear that California and its partner states will do everything possible to challenge this reckless ruling.”

Caitlin Oakley, a spokeswoman for the Department of Health and Human Services, said Monday that because Judge O’Connor had not issued a final judgment or an injunction, the department “will continue administering and enforcing all aspects of the A.C.A. as it had before the court issued its decision.”

The lawsuit was filed by Texas and 19 other states. The individual mandate was enforced by a tax penalty on people who go without insurance, and the Supreme Court upheld it in 2012 as an exercise of Congress’s taxing power. But as part of the tax overhaul that President Trump signed last December, Congress reduced the penalty to zero dollars, starting in 2019. Texas and the other plaintiffs contend that the mandate will then lose its constitutional justification.

On Friday, Mr. Trump hailed the judge’s decision as “great news for America!”

But the coalition of states led by California told the judge on Monday that their citizens would face “devastating harm from the invalidation” of the Affordable Care Act.

“The law’s provisions are so interwoven in virtually every aspect of the public and private health care system that the elimination of the A.C.A. will cause grievous immediate and long-term harm to Americans’ health and financial security, to the health care system, and to federal and state budgets,” the coalition said in a legal brief.

“If the A.C.A. is invalidated, nearly 12 million Americans who gained coverage through the Medicaid expansion would become uninsured,” the coalition said. “An additional eight million low-income residents will lose access to billions of dollars in tax credits” that help them pay premiums for private insurance.

Judge O’Connor’s decision left several issues unresolved, but California and its allies said he should allow an immediate appeal on an important legal question: “whether the A.C.A. remains in force, wholly or in substantial part, after the passage” of the tax cut law.

Gov. Greg Abbott of Texas, a Republican, said on Monday that his state would try to devise a replacement for the Affordable Care Act.

“If Obamacare remains struck down on appeal Texas will be ready with replacement health care insurance that includes coverage for preexisting conditions,” Mr. Abbott said in a Twitter post.


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