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Ever since Judge Reed O’Connor of the Northern District of Texas ruled a year ago that the Affordable Care Act was unconstitutional, the country has been waiting for the next arbiter — a federal appeals court — to weigh in on the fate of the landmark health law. On Wednesday, that ruling finally came. But it offered little clarity. The judges from the Court of Appeals for the Fifth Circuit, in a 2-1 decision, ruled that one key element of the law — the mandate requiring people to have insurance — was unconstitutional. But they sent the rest of the case back to Judge O’Connor for what the dissenting judge called a “do-over,” asking him to give it another think on the question of whether other parts of the law should be struck down too. (Hoffman, 12/19)

The federal appeals court ruling striking down the Affordable Care Act’s requirement that people have health insurance left hanging key questions about what happens to other provisions of the law, like coverage for preexisting conditions. ... What happens next? It’s a bit uncertain. The appeals court told O’Connor to go over the ACA with a “finer-toothed comb” to determine which provisions of the legislation could be severed from the individual mandate, but Democratic attorneys general are weighing whether they want to appeal the case directly to the Supreme Court, which twice before has upheld the law. It’s a different court now, with a more conservative bent, but the same five justices who upheld the heart of the law in 2012 remain. (Santana, 12/19)

What’s the impact on 2020 Democratic candidates? It’s mixed. Had the court struck down the entire law, Democratic presidential and congressional candidates would have been confronted with a crisis and likely pivoted from discussions about “Medicare for All” to promoting ways they’d fortify Obamacare. Wednesday’s decision gives them another opportunity to voice support for the law while continuing to debate how best to achieve universal coverage. Democrats no doubt are mindful of the big gains they registered in the midterm elections by bashing Trump and GOP efforts to undermine the law. (Bettelheim and Luthi, 12/19)

An apparent setback for the Affordable Care Act is actually a win for health insurers. The Fifth U.S. Circuit Court of Appeals, in a 2-1 decision, struck down the law’s requirement that most people carry health insurance or pay a penalty. That seems like a problem given that health insurers have flourished ever since what is commonly known as Obamacare became law in 2010. (Grant, 12/19)

The 5th Circuit Court of Appeals' reluctance to decide the fate of the Affordable Care Act cuts a break for the Republican lawmakers who sought to topple it while sowing uncertainty into healthcare markets that only recently found their footing. The 5th Circuit ruled 2-1 on Wednesday that the already toothless individual mandate is unconstitutional but remanded the case back to a federal judge in Texas to determine how much of the landmark healthcare law must fall along with it. U.S. District Judge Reed O'Connor previously struck down the ACA in entirety. (Livingston, 12/19)

Kaiser Health News: KHN’s ‘What The Health?’: ACA Still Under A Cloud After Court Ruling

The fate of the Affordable Care Act continues to be in doubt after a federal appeals court ruling in New Orleans. By a 2-1 vote, the three-judge panel ruled that the “individual mandate” provision of the health law — which requires people to have health coverage — is unconstitutional now that Congress has reduced the penalty to zero. But the judges sent the case back to the lower court to determine how much else of the law can remain in light of that finding. (12/19)

Pepper Nappo-Mead, a young Derry mother with pre-existing conditions, said she finds “terrifying” the federal appeals court ruling that judged the Affordable Care Act to be unconstitutional. But during a conference call Thursday, health care advocates stressed a new state law ensures that even if Obamacare was thrown out in court, New Hampshire would still cover some but not all of its key provisions. (Landrigan, 12/19)

Attorney General Josh Kaul and Gov. Tony Evers were able to fulfill a campaign pledge earlier this year and get Wisconsin out of an Obamacare lawsuit. But in the wake of Wednesday's federal court decision to strike down a key part of the Affordable Care Act, there's little Kaul can now do but push from the outside. (Glauber, 12/19)

Connecticut Attorney General William Tong on Thursday said he will join other “blue” states in appealing a federal court’s decision that puts the future of the Affordable Care Act in jeopardy. “We will continue our fight against the attack on our nation’s healthcare system and the millions of Americans who have gained coverage and quality healthcare under the Affordable Care Act,” Tong said. The decision of the 5th U.S. Circuit Court of Appeals puts at risk health care coverage for 250,000 Connecticut residents who have benefited from the ACA’s expansion of Medicaid. (Radelat and Carlesso, 12/19)