A federal judge in Texas who declared the Affordable Care Act unconstitutional earlier in December stayed his ruling pending an appeal since residents in many states have already purchased their health insurance plans for 2019.

U.S. District Judge Reed O'Connor of the Northern District of Texas broadly upheld his initial Dec. 14 ruling, but said Americans would face great uncertainty during the appeal without a stay. O'Connor did say the states intervening to defend the ACA failed to show a likelihood they could succeed on appeal at the U.S. Court of Appeals for the Fifth Circuit.

In entering a partial final judgment and stay, O'Connor said Congress can sever the individual mandate from the ACA, but that the courts cannot do that. O'Connor added that congressional intent clearly indicated lawmakers did not intend to sever the individual mandate.

“The more courts step into breaches for Congress, the more courts will be called upon to step into breaches for Congress,” O'Connor wrote Saturday. “That would represent a fundamental shift in the Constitution's careful balancing of powers—not only on the Judiciary-Legislature plane, but also on the citizen-government plane.”

O'Connor's initial 55-page ruling issued Dec. 14 found that last year's congressional action eliminating the penalty imposed by the ACA's individual mandate made the whole law unconstitutional. O'Connor's decision said the demise of the mandate rendered the entire law invalid because it could not be severed from the mandate.

Democratic attorneys general who intervened in the case immediately vowed to appeal to the Fifth Circuit, putting the ACA on the path to review in the next year or so by the U.S. Supreme Court, which upheld the law in 2012.

O'Connor's underlying ruling came after “health insurers have already locked in benefits and prices for 2019 health coverage and are almost done with ordinary applicant enrollment for 2019 coverage,” according to affiliate publication Benefits Pro.

The 17 state attorneys general defending the ACA in lieu of the DOJ, which announced in June it would not defend the ACA, said O'Connor's decision lacked clarity, and filed an expedited motion seeking to continue the defense of the ACA. The motion also asked O'Connor to certify the opinion so it could be immediately appealed, or to stay the ruling pending an appeal.

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