The Affordable Care Act could be headed back to the Supreme Court for the third time after a federal judge in Texas ruled Friday that the law is unconstitutional.

Judge Reed OConnor of the U.S. District Court for the Northern District of Texas issued the opinion in a lawsuit brought in February by Republican officials in 20 states led by Texas Attorney General Ken Paxton . Those officials contended that the entire law should be stricken because Congress earlier this year repealed the fines known as shared responsibility payments that people without health coverage had to pay under the Affordable Care Acts individual mandate. OConnor agreed.

The court finds the individual mandate can no longer be fairly read as an exercise of Congresss tax power and is still impermissible under the interstate commerce clause meaning the individual mandate is unconstitutional. [T]he court finds the individual mandate is essential to and inseverable from the remainder of the ACA, OConnor wrote in his opinion.

If the ruling stands, the Affordable Care Acts insurance regulations would disappear and, along with them, the health coverage for millions of people who gained private insurance or Medicaid coverage under the 2010 law signed by President Barack Obama . Specifically, the laws guarantee of coverage for people regardless of their pre-existing conditions, financial assistance for private insurance, rules establishing a basic minimum set of benefits insurance policies must cover and more would vanish. Since OConnors ruling throws out the entire statute, the rest of the ACA, such as its expansion of Medicaid to low-income adults, also is stricken.

In short, this ruling would deal severe damage to the American health care system. It also would eradicate one of Obamas most significant accomplishments. According to an analysis by the Urban Institute, eliminating the Affordable Care Act would increase the national uninsured rate by 50 percent and lead to more than 17 million people losing health coverage.

President Donald Trump celebrated the ruling in a pair of Twitter posts Friday night. As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions, he wrote in one post. In another Trump wrote, Great news for America!

OConnors ruling does not include a stay to delay it from taking effect, so the Affordable Care Act is now technically unconstitutional. The ruling will be appealed, however, making it unlikely that the laws health insurance markets, funding and regulations will immediately go away.

Todays ruling is an assault on 133 million Americans with preexisting conditions, on the 20 million Americans who rely on the ACA for health care, and on Americas faithful progress toward affordable health care for all Americans, California Attorney General Xavier Becerra said in a news release . The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court. Todays misguided ruling will not deter us: Our coalition will continue to fight in court for the health and wellbeing of all Americans. Becerra led the team of Democratic state attorneys general who defended the Affordable Care Act in the case.