Is the Affordable Health Care Act Affordable and Legal?

The law required all persons to acquire health insurance or face a financial penalty.

A commentary by James Edwin Gibson

Officially named the Patient Protection and Affordable Health Care Act[1], the health care reform bill signed into law by President Barack Obama in 2010 created many changes in health care coverage in the United States.

Its title is often shortened to just the Affordable Health Care Act. It is also often referred to as Obamacare. Some call it “the unaffordable health care act.”

The law required all persons to acquire health insurance and imposed a financial penalty on persons who did not.

Change to an Obamacare Requirement and a Lawsuit

A tax cut bill passed by Congress in 2017 eliminated the financial penalty to individuals for not purchasing insurance effective this year (2019), so under current laws persons filing income taxes next year for 2019 will not need to pay the penalty if they lack health care coverage. 

A 2018 lawsuit claimed that eliminating this financial penalty made the whole law unconstitutional.  In December 2018 a U.S. District Court judge in Texas judge agreed. The case was appealed.

Yesterday (July 9, 2019) a federal appeals court panel in New Orleans heard oral arguments in the case. This has been reported by various news sources, including the New York Times[2], Reuters[3], Politico[4], CNN[5], NPR[6], and the Associated Press[7].

Whatever this appeals court eventually decides, the case will likely be appealed to the United States Supreme Court.

How the United States Supreme Court ultimately rules on this case, perhaps next year (2020), will have major implications for health care.

Ideally, it would be great if the Democratic-controlled House of Representatives, the Republican-controlled Senate, and President Trump could reach agreement on health care reforms that retain the good parts of Obamacare while either eliminating or improving the bad parts. But, given deep divisions between Democrats and Republicans on the issue, this seems unlikely to me.

Perhaps the Biggest Problem With the ACA

Perhaps the biggest problem with the “Affordable Health Care Act” (ACA) is that it made health care coverage more expensive for most persons. Much more expensive for millions.

Even with partial subsidies, many persons experienced more expensive coverage than before the ACA. And, due to deductibles, many of those who purchased insurance felt they couldn’t afford to use it.

One reason for the cost increase is the need for extra money to pay for coverage for pre-existing conditions, many of which are preventable. Under the old system prior to the ACA:

·  insurance companies often excluded coverage for preexisting conditions,

·  insurance companies cancelled coverage when it came up for renewal if expensive health problems developed,

·  and/or a person experiencing significant health care problems lost health coverage due to losing their job because of health issues that prevented them from working at their job. 

Churches and others sometimes helped persons facing huge medical bills under the old system, but many persons suffered from lack of coverage. The old insurance system offered relatively cheap coverage for most persons, partially by not covering the relatively few who cost the most to insure.

Arguably, most persons are worse off now under Obamacare, but the millions of persons who benefit from it would hate to lose their Obamacare coverage.


The Solution?

What is the solution? As I wrote in a March Craft News Report article[8], the greatest need in this country regarding health care is better preventive care, since most health care problems and costs are preventable.

If we take action to prevent most preventable health care problems, we can provide quality coverage to virtually everyone significantly cheaper than we do now.

But, getting persons to avoid abusing legal and illegal drugs, to exercise regularly, to eat a proper diet, etc., is easier written than attained. Still, making significant progress in this may be easier than getting Republicans and Democrats to come together on a quality compromise bill that fixes Obamacare’s weaknesses.

I hope and pray that somehow constructive changes occur before next year when the United States Supreme Court will likely make a decision in this court case. Far too often, our court system seems led (or forced?) to do things as a result of what I consider inappropriate actions by our legislative and executive branches.


[1] “Patient Protection and Affordable Health Care Act”;; website accessed July 10, 2019;

[2] Abby Goodnough; “Appeals Court Seems Skeptical About Constitutionality of Obamacare Mandate”; New York Times; July 9, 2019; website accessed July 10, 2019;

[3] Nate Raymond; “U.S. appeals court signals sympathy to bid to strike down Obamacare”; Reuters; July 9, 2019;

[4] Paul Demko; “Appeals court skeptical Obamacare can survive”; Politico; July 9, 2019; website accessed July 10, 2019;

[5] Tami Luhby, Dan Berman, and Joan Biskupic; “Republican-appointed judges appear to side with Texas challenge to Obamacare”; CNN; July 9, 2019; website accessed July 10, 2019;

[6] Julie Rovner; “The Affordable Health Care Act Is Back in Court”; 5 Facts You Need to Know”; July 9, 2019; website accessed July 10, 2019;

[7] Kevin McGill and Rebecca Santana; “Validity of Obama health care law at issue in appeal hearing”; AP News; July 9, 2019; website accessed July 10, 2019;

[8] James Edwin Gibson; “TRUE HEALTH CARE REFORM: BETTER PREVENTIVE CARE”; Craft News Report; submitted March 30, 2019; webpage accessed July 10, 2019; (This article is almost identical to a Google Blogger article published earlier March 30, 2019, which in turn was condensed from a chapter in the author’s book True Christianity: It May Not Be What You Think.)


This piece is being submitted to Craft News Report on July 10 2019.

Copyright © 2019 James Edwin Gibson. James is the author of the books True Christianity: It May Not Be What You Think (2014, second edition 2015, third edition 2017) and Several True (I Think) Stories: Can Truth Be Stranger Than Fiction? (2016, second edition 2017). You may contact James at regarding this column. James thanks his friend Paul for publishing it on his website, thanks you all for reading, and hopes you all enjoy God’s blessings!