The federal court will hear arguments from 18 states against the healthcare law, and support from 16 states plus the U.S. House of Representatives. File Photo by Kevin Dietsch/UPI | License Photo

July 9 (UPI) -- A federal appeals court will hear arguments from 18 states and the U.S. Department of Justice on Tuesday in a case that has the potential to derail the Affordable Care Act nearly a decade after it took effect.

The traditionally Republican states will ask a panel of federal judges in New Orleans to repeal the ACA, seven months after U.S. District Judge Reed O'Connor ruled former President Barack Obama's signature healthcare law is unconstitutional.


The opposed states argue the law is a cavalier attempt to mandate Americans buy health insurance the government deems suitable and necessary. On the other side, 16 states led by California and the Democratic-controlled U.S. House will defend the sweeping reform package, arguing it's provided coverage for 20 million Americans who otherwise would not have it.

President Donald Trump campaigned in 2016 on the promise to repeal and replace the ACA. A GOP plan in Congress to replace the ACA, the American Health Care Act, did not find enough support.

Gov. Greg Abbott of Texas, one of the lead states fighting the law, has said his government is ready with "replacement healthcare insurance" that includes coverage for pre-existing conditions. The state argues that Congress' removal last year of the ACA's individual mandate has transformed the legality of the entire law.

"The mandate now raises no revenue and therefore cannot by any conceivable definition be considered a tax," Texas argues in its lawsuit. "Stripped of its tax status, the individual mandate is nothing more than an unconstitutional congressional mandate to purchase health insurance."

ACA supporters argue, however, that federal lawmakers kept all other provisions of the ACA after the tax penalty was pulled -- and that O'Connor's decision "conflicts with the plain intent of Congress and would create chaos and harm tens of millions of Americans."

Arguments Tuesday will be heard by a trio of 5th Circuit judges, two of whom were appointed by Republican presidents. The case could end up at the U.S. Supreme Court, which has a conservative majority.

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