obamacare

You're forgiven if in the holiday blur you missed that a federal appeals court in New Orleans has once again put the future of the Affordable Care Act in doubt. Or if you missed the news last week that a group of Democratic state attorneys general has asked the Supreme Court to hear the case in this term — which ends in June. That would mean a decision could come right in the middle of the 2020 presidential and congressional campaigns.

Whether you think the new decade starts at midnight Tuesday or a year from then, the eve of 2020 seems like a good time to look back on the top political stories of the 2010s.

Updated at 8:28 p.m. ET

A federal appeals court panel in New Orleans has dealt another blow to the Affordable Care Act, agreeing with a lower-court judge that the portion of the health law requiring most people to have coverage is unconstitutional now that Congress has eliminated the tax penalty that was intended to enforce it.

But it is sending the case back to the lower court to decide how much of the rest of the law can stand in light of that ruling.

More than $12 billion is at stake for the nation's health insurers Tuesday when the Supreme Court hears a case involving the Affordable Care Act.

For the federal government, the potential damages could be far greater, as its reputation as a reliable partner to private businesses is on the line.

Unlike earlier Obamacare cases before the high court — where the entire 2010 law and health coverage for millions of Americans was at risk — the latest case has largely flown under consumers' radar.

While many Capitol Hill Republicans would like to avoid another public debate about whether to repeal the Affordable Care Act, President Trump and his appointees keep bringing it up — promising their own health plan that would be "phenomenal" and make the GOP "the party of health care."

President Trump, bowing to political reality, says he is putting off his thoughts of finding a replacement for the Affordable Care Act until after the 2020 election.

In remarks to reporters Tuesday, Trump said, "I wanted to put it after the election because we don't have the House." But it became clear that he didn't have support for a replacement to Obamacare in the GOP-led Senate, either.

Updated at 1:30 p.m. ET

In a significant shift, the Trump administration says the entirety of the Affordable Care Act should be struck down in the courts. Previously, the administration had pushed to remove the law's protections for people with pre-existing conditions but had not argued in court that the whole law should be struck down.

The federal judge in Texas who ruled the Affordable Care Act unconstitutional earlier this month said that the law can remain in effect while under appeal.

U.S. District Court Judge Reed O'Connor wrote in his ruling filed on Sunday that "many everyday Americans would otherwise face great uncertainty during the pendency of appeal."

Robert and Tiffany Cano of San Tan Valley, Ariz., have a new marriage, a new house and a 10-month-old son, Brody, who is delighted by his ability to blow raspberries.

They also have a stack of medical bills that threatens to undermine it all.

In the months since their sturdy, brown-eyed boy was born, the Canos have acquired nearly $12,000 in medical debt — so much that they need a spreadsheet to track what they owe to hospitals and doctors.

The number of Floridians who enrolled in the Affordable Care Act this year increased by more than 55,000 compared to last year.

If last Friday's district court ruling that the Affordable Care Act is unconstitutional were to be upheld, far more than the law's most high-profile provisions would be at stake.

In fact, canceling the law in full — as Judge Reed O'Connor in Fort Worth, Texas, ordered in his 55-page decision — could thrust the entire health care system into chaos.

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Florida's largest health insurer has seen a 45 percent drop in opioid prescriptions since it stopped paying for OxyContin.

It has been almost a year since Florida Blue announced that it would no longer provide prescription payments for the popular painkiller and would require advanced permission for any opioid prescription lasting longer than seven days.

It replaced OxyContnin in its drug plans with a different opioid, Xtampza. That drug is designed to be more difficult to crush, making it tougher to snort or inject.

The Affordable Care Act faces a new legal challenge after a federal judge in Texas ruled the law unconstitutional on Friday. The decision risks throwing the nation's health care system into turmoil should it be upheld on appeal. But little will be different in the meantime.

"Nothing changes for now," says Julie Rovner, chief Washington correspondent of Kaiser Health News.

President Trump called a Friday ruling striking down the Affordable Care Act "Great news for America!" Democratic lawmakers rushed to decry the decision, calling it "monstrous" and "harmful." And Republican lawmakers remained mostly quiet Saturday.

Like millions of Americans in this final week of open enrollment for the Affordable Care Act marketplaces, Diane McCabe is shopping for health insurance.

"At my age, I can't go without it, even though I'm healthy now," says McCabe. She's 62 and a self-employed real estate agent in Luzerne County, Pa. "But the process is frustrating, and the expense significant."

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