“The future of the Affordable Care Act (ACA), the millions of Americans who depend on it, and, frankly, the American health care system…were on the line in a federal courthouse in New Orleans on Tuesday,” writes health law expert Timothy S. Jost in his new post for To the Point.

Jost, an emeritus professor with the Washington and Lee University School of Law, is referring to oral arguments heard Tuesday in the appeal of Texas v. U.S. , the case in which a district court judge ruled the entire ACA was invalid. The plaintiffs — 18 Republican states and two individuals, joined by the United States on the appeal — argue that because the individual mandate to have health insurance is “inseverable” from the rest of the law, the entire ACA was invalidated when Congress in 2017 zeroed out the mandate’s tax penalty for not having coverage. The plaintiffs maintain this is because of an earlier Supreme Court ruling that the mandate is constitutional only as a tax and not as a command to have insurance.

Jost believes the judges hearing the case may not fully understand what would happen to the U.S. health care system if the ACA’s deeply entrenched health care reforms were to be wiped from the books. “Suggesting that Congress could readily 'fix' the problems caused by the lower court’s decision or that a supposed 'fix' other than reversal is even needed — or possible — reveals a lack of understanding of the scope of the ACA and a frightening degree of irresponsibility.”