On December 14, 2018, in Texas v. United States, a federal judge in the Northern District of Texas ruled the entirety of the Patient Protection and Affordable Care Act (ACA) to be unconstitutional due to the elimination of the individual mandate in last year's Tax Cuts and Jobs Act (Tax Act). The court ruled that the individual mandate was such an essential provision of the ACA that rewriting the ACA without it is beyond the power of a federal court and that the individual mandate is inseverable from the ACA's remaining provisions.

The court's decision sent shockwaves through the legal community and news outlets—particularly as the ACA's annual enrollment period for 2019 was set to end on December 15, 2018. However, while the decision of the court should not be understated, it will be appealed to the U.S. Court of Appeals for the Fifth Circuit (and almost certainly after that to the U.S. Supreme Court) and the ACA remains in place during the appeals process.

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