The federal government doesn’t have to pay insurers billions of dollars under an Affordable Care Act program aimed at enticing them into the markets by helping cover their financial risks, a divided federal appeals court ruled Thursday.

In a case brought by Moda Health Plan Inc., the ruling is a blow to insurers hoping to recoup money they say they were owed under the 2010 health law.

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Last week was an amazing and unusual week at the Department of Justice, and it went largely unnoticed by the mainstream media. Attorney General Jeff Sessions, with the approval of President Trump, submitted court filings in two lawsuits agreeing that Obamacare will be unconstitutional as of Jan. 1, 2019, and that DACA is and always has been unlawful. Thus, DOJ will not defend Obamacare nor will it defend DACA on the merits.

Not since the Obama administration flipped its position on DOMA has the DOJ declined to defend something this important. And unlike the DOMA case, in both the Obamacare case and the DACA case, DOJ is relying on existing rulings from the Supreme Court and the 5th Circuit, respectively, in formulating its positions.

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Consumers and insurers face new uncertainty with the Justice Department’s assertion this week that key provisions of the Affordable Care Act are invalid.

In a brief filed Thursday, the department asked a federal court to unwind the health law’s protections for individuals with existing medical conditions, such as diabetes or asthma. The law, known as Obamacare, prohibits insurers from refusing to sell coverage to people with pre-existing conditions or from charging them more than healthy consumers.

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In a court case filed by Texas and 19 other states, the Justice Department said in a brief on Thursday that the requirement for people to have insurance — the individual mandate — was unconstitutional.

If that argument is accepted by the federal court, it could eviscerate major parts of the Affordable Care Act that remain in place.

A definitive court ruling could be months away and appeals of any decision could take many more months, during which the law is likely to stay in effect.

Two self-employed Texans, John Nantz and Neill Hurley, have leading roles in the latest legal effort to kill Obamacare.

The men are the named plaintiffs in a lawsuit by 20 states that argues Congress fatally undercut the law when it repealed the individual mandate penalty in tax cut legislation. Nantz and Hurley say the mandate compels them to buy costly insurance that doesn’t fit their needs — even though the financial penalty for not complying is disappearing next year.

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A Maine state judge said Thursday that Gov. Paul LePage’s administration has a “duty to enforce” a voter-passed law to expand Medicaid to low-income adults.

Kennebec County Superior Court Justice Michaela Murphy’s comment came during oral arguments in a lawsuit brought by advocacy groups to force the LePage administration to implement the Medicaid expansion overwhelmingly passed by Maine voters last November.

The judge did not indicate when she would issue a ruling, though it’s expected she will rule within a week or so. The losing side is almost certain to appeal.

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Almost no one saw it coming.

In 2012, Chief Justice John Roberts famously ruled the Affordable Care Act’s provision mandating most people purchase health insurance or else pay a fine constitutional on the basis that Congress has the authority to tax individuals, and the so-called Obamacare “fine” is effectively a tax.

As the now-deceased Justice Antonin Scalia pointed out in his dissenting opinion, in classifying the Obamacare penalty as a “tax,” Roberts ignored history, the language of the healthcare law, statements made by the Obama administration and Democrats in Congress, and common sense. (The obvious difference between a fine and a tax is that the purpose of a tax is to raise revenue, not to force people to behave in a particular way.)

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New York and Minnesota officials have settled a lawsuit against the Trump administration over its decision to slash federal funding for the states’ health plan programs that cover certain low-income people.

A federal judge in the U.S. District Court for the Southern District of New York dismissed the case after the HHS agreed to pay $151.9 million to New York and $17.3 million to Minnesota by May 14 to fund the states’ Basic Health Programs, which together cover 800,000 people.

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This week the Texas Public Policy Foundation, on behalf of individual Texans burdened by Obamacare, filed to join the Texas-led, 20 state lawsuit challenging the Affordable Care Act as unconstitutional as amended by the Tax Cuts and Jobs Act of 2017.

“The U.S. Supreme Court has already held that the individual mandate absent the tax penalty is unconstitutional,” said Robert Henneke, general counsel and director of the Center for the American Future at TPPF. “Now that Congress has set the tax penalty at zero, it no longer performs the essential function of a tax, which is to generate revenue for the federal government. Under the Supreme Court’s own analysis in the NFIB v. Sebulius case, there is no remaining legal basis on which to uphold the individual mandate, which cannot be severed from the Affordable Care Act as a whole. By joining this lawsuit, the Foundation seeks to accomplish what Congress has failed to do — fully strike down this unconstitutional law.”

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The only consistent characteristic of the Affordable Care Act (ACA) is its ability to generate litigation. The gift that keeps on giving for Obamacare opponents seems to defy common law doctrines curbing the practices of champerty and maintenance (frivolous lawsuits).

Last month 20 state attorneys general and two governors launched the latest lawsuit in federal district court in Texas, arguing that the upcoming repeal of tax penalties for the ACA’s individual mandate, as of January 2019, means that the entire law has become unconstitutional (or at least a number of its related insurance regulation provisions).

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