His comments came after a federal judge in Texas struck down the Affordable Care Act on Friday, and after Indiana Attorney General Curtis Hill appeared on Fox News' "Fox and Friends" to say the Texas ruling marks an opportunity for Congress to act.
IN was one of 20 states involved in the lawsuit that challenged the constitutionality of the Affordable Care Act. Certain providers of substance abuse treatment, emergency services and mental health services could also be negatively impacted.
The states, which support the health care law, said the ruling on Friday, by Judge Reed O'Connor of the Federal District Court in Fort Worth, had caused huge confusion about whether the law was still in effect, and whether consumers were still entitled to its benefits and protections. If it's upheld, tax-exempt hospitals and health-care systems could see "a broad diminution in credit quality over time" as they face higher costs from patients that can't pay their medical bills, S&P said in its report.
In a landmark decision in 2012, the Supreme Court upheld the law by declaring that mandate was actually a tax, which Congress had the authority to impose. "In our view, the demise of the ACA would become the number one issue in the 2020 presidential election", it said.
The individual mandate requires taxpayers to obtain health coverage for themselves and their families.
A Supreme Court ruling in their favor would be Republicans' only shot at overturning the law in the foreseeable future, with Democrats taking control of the House in January. "Pending the appeal process, the law remains in place".
Judge O'Connor points to the "findings" from the original ACA itself to claim that the mandate was "essential" to various provisions of the law, but those findings were included to bolster arguments that the mandate was constitutional as a legal requirement and were not meant to make the rest of the law dependent on the mandate.
"The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court", he said. They also argued in the alternative that should the individual mandate be invalidated, that provision should be severed from the ACA, leaving the rest of the law intact in accordance with congressional intent.
"This ruling would have been awful for Republicans if they still controlled the House, but because they don't, they have the opportunity to sit back and focus on message and really this has the potential to give Republicans second life on this issue", GOP strategist Ford O'Connell said.
California Attorney General Xavier Becerra in a statement said the Democrats would appeal Friday's decision.
The President tweeted on Friday: "Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions".
In Friday's decision, O'Connor said that because Congress lowered the penalty to zero previous year, the mandate no longer came with a "tax" and is unconstitutional. But with that "tax" - or penalty - having been removed starting next year, Republicans challenging the law in this case argued the program is now illegal.
Without an immediate legal basis for the defendants to appeal, the judicial review process could result in a prolonged period of uncertainty for healthcare industry players and policymakers alike, even if the ACA is ultimately upheld again in part or whole, whether by the Fifth Circuit or Supreme Court.