On February 26, 2018, Texas1 filed a complaint for declaratory and injunctive relief against the United States, the U.S. Department of Health and Human Services, and the U.S. Internal Revenue Service alleging that the Patient Protection and Affordable Care Act (a/k/a the Affordable Care Act or Obamacare) was unconstitutional. Six years earlier, in National Federation of Independent Business v. Sebelius, the U.S. Supreme Court upheld the individual mandate in the Affordable Care Act, which “require[d] most Americans to maintain ‘minimum essential’ health insurance coverage,” as a valid exercise of Congressional power under the Taxing Clause. The plaintiffs now argue that since Congress passed and President Trump signed into law the Tax Cuts and Jobs Act of 2017, which eliminated the tax penalty of the Affordable Care Act, the individual mandate is no longer a valid exercise of Congressional power under the Taxing Clause since removal of the tax penalty disconnects the individual mandate from the collection of taxes.
Plaintiffs further argued that without the individual mandate, the rest of the Affordable Care Act must fall since the individual mandate underpins the guaranteed-issue and community-rating requirements of the Affordable Care Act. The guaranteed-issue requirement prohibits health plans from denying coverage to applicants with pre-existing conditions. The community-rating requirement prohibits health insurers from charging higher premiums to persons with pre-existing conditions.