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(Think Progress) – Much of the Affordable Care Act must be defunded and millions of Americans must lose their health insurance, according to an opinion issued Tuesday by Judge Ronald A. White, an Oklahoma federal judge appointed to the bench by George W. Bush.
White’s opinion reaches the same result reached by two Republican appeals court judges in a similar case, although that decision was later withdrawn by the full appeals court. To date, nine federal judges have considered this question of whether much of the law should be defunded. Only three — all of whom are Republicans — have agreed that it should be.
The theory behind this lawsuit, Pruitt v. Burwell
, is that although the Affordable Care Act gives states a choice between setting up their own health insurance marketplaces or permitting the federal government to do it for them, health exchanges run by the federal government cannot provide subsidies to help insurance customers pay for their insurance. Should this theory ultimately be embraced by the courts, it will likely trigger a “death spiral”
of premium spikes that will drive more and more consumers out of the insurance market, until the markets eventually collapse.