Appeals court strikes down ACA's individual mandate

Just about the time the House of Representatives voted to forward their  "Impeachment resolution to the U.S. Senate, a ghost of another haunting has risen from the dead.

The Individual Mandate of the ACA assures that no one can be denied health insurance based upon previous medical conditions.

A federal appeals court on Wednesday ruled that the Affordable Care Act's individual mandate is unconstitutional, but ordered a lower court to take a fresh look at how much of the rest of the law should fall along with it.

What's next: This decision will likely keep the ACA's protections for pre-existing conditions in legal limbo well past the 2020 election.

The intrigue: Republican attorneys general have argued that congressional Republicans’ 2017 tax law, which nullified the ACA's individual mandate, made that policy unconstitutional.

• A panel of the 5th Circuit Court of Appeals said Wednesday that it agrees.
• Republicans, and the Trump administration, have said the courts should strike down the entire law along with the mandate.
• The 5th Circuit wrestled during oral arguments over how much of the law to strike down, ultimately deciding to kick that question back to the lower court for a new hearing. That lower court previously said the entire law would have to go.

Yes, but: The individual mandate is now essentially toothless, and it turned out not to be particularly effective when it was in effect.

• So, if the court is inclined to strike down the mandate alone, letting the rest of the law stand, that would be a much safer proposition than it appeared to be in 2012.

Go deeper: Government funding bill deal will repeal key ACA taxes

Why it matters: The decision is a colossal win for the health care industry.

• If this wasn't good enough news for the industry, the deal won't address surprise medical bills — and it avoids prescription drug prices except for the CREATES Act, which helps generics get to market faster.
• The taxes have been repeatedly delayed. And while the industry has pushed for their repeal for years, it hasn't yet been successful.

Between the lines: Voters are decidedly not asking Washington to lift industry taxes while avoiding dealing with two of the most popular health care issues, but if that's how this plays out, it's a great indicator that the industry's lobbying strength is as good as ever.

• It's also a good sign that cost control — the intention of the Cadillac tax, a 40% excise tax on the most generous employer plans — is still not very popular with lawmakers, even as health care costs continue to rise.
• The tax was expected to raise $200 billion over 10 years.

The other side: The industry says that the ACA taxes end up getting passed along to patients.

Go deeper:

• The Affordable Care Act's free health plans
• SCOTUS seems to side with insurers in ACA risk corridor case
• The return of the ACA wars

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