The AHA, joined by the Federation of American Hospitals, Catholic Health Association of the United States, and Association of American Medical Colleges, today urged a federal district court in Texas to deny a request by 20 Republican-led states to declare the Affordable Care Act unconstitutional because the Tax Cut and Jobs Act repealed the tax penalty enforcing the individual mandate. “[W]hen Congress had the choice before it in 2017, it explicitly chose to zero out the penalty attached to the mandate and do nothing else,” the groups said in a friend-of-the-court brief. “That is as clear a sign of congressional intent as the Court could hope for. Ruling otherwise and striking down the entire ACA would devastate this nation’s health care system, its patients, and the hospitals they rely on for care. Nothing requires that catastrophic result. This Court should decline to give Plaintiffs the result they seek – repeal of the entire ACA – judicially when they could not secure it through the political process.” The Department of Justice last week told the court it would no longer defend the ACA’s individual mandate or protections for people with pre-existing conditions, calling the provisions inseparable. Sixteen Democratic-led states also filed a brief defending the ACA.