NASHVILLE - State Democrats and health care activists are denouncing a federal judge's ruling that strikes down the Affordable Care Act, warning of "cruel" consequences for nearly 1.7 million Tennesseans with pre-existing health problems, as well as a quarter million people who obtain insurance coverage through the ACA.
They're also criticizing Tennessee Attorney General Herbert Slatery, who joined fellow Republican state attorneys general in successfully challenging the 2010 law, also known as Obamacare.
And they're calling on Republican U.S. Sen. Lamar Alexander, chairman of the Senate Health Committee, to protect Tennesseans should the ruling ultimately be upheld by the nation's highest court.
The law remains in place for now. Democratic state attorneys general say they will appeal the decision.
But criticisms rained down in Tennessee Friday night and into Saturday after U.S. District Court Judge Reed O'Connor on Friday made his ruling.
O'Connor held that because a 2017 congressional tax bill eliminated penalties for adults who don't have health insurance, the ACA is unconstitutional. The U.S. Supreme Court earlier in 2012 upheld the law and the mandate to have insurance, saying it was constitutional because it fell under Congress' taxing power.
In their new challenge to the law led by Texas, 20 state attorneys general, including Slatery, argued that with the penalty gone, the individual mandate became unconstitutional. O'Connor, a Republican appointee, agreed and ruled remaining parts of the law couldn't be severed from it.
The Rev. Morgan Gordy, pastor of Christ Lutheran Church in Nashville and a member of the Southern Christian Coalition, said "scripture tells us that health care is our responsibility. To invalidate the ACA is an immoral act. It robs people of their ability to seek and receive health care."
Calling the issue a matter of "life and death," Gordy said "I urge Attorney General Slatery to remove Tennessee from this lawsuit."
Efforts to reach a spokesperson for Slatery were not immediately unsuccessful Saturday. Unlike most state attorneys general, including those participating in the lawsuit, Slatery is not popularly elected. The Tennessee Supreme Court appoints the state's chief lawyer.
Meanwhile, advocates and others are demanding action from Alexander.
"Sen. Alexander, I believe, said that this was never their intent but they've done absolutely nothing to ensure that this protection remains in effect," said Tennessee Senate Minority Leader Jeff Yarbro, D-Nashville. "Congress has treated this like a political football for years when, for real human beings, it's a day-to-day problem.
Yarbro said "it's about time for people to take their responsibilities seriously and actually do what's needed to strengthen health care protection in the United States."
In a statement released later, Alexander said "if the U.S. Supreme Court eventually were to agree that Obamacare is unconstitutional - which seems unlikely, however poorly the law was written - I am confident that any new federal law replacing it will continue to protect Americans with pre-existing conditions who buy health insurance."
Pre-existing conditions include cancer, diabetes mellitus, rheumatoid arthritis, some types of heart disease and other illnesses.
President Donald Trump hailed the ruling on Friday, tweeting that "ObamaCare was just ruled UNCONSTITUTIONAL by a highly respected judge in Texas. Great news for America!"
He also stated that "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. Mitch and Nancy, get it done!"
That's a reference to U.S. Senate Majority Leader Mitch McConnell, R-Ky., and U.S. Rep. Nancy Pelosi, a California Democrat expected to become the new House speaker in January after Democrats won control of the chamber in November elections from Republicans.
While congressional Democrats like U.S. Rep. Steve Cohen of Memphis and Jim Cooper of Nashville denounced the court ruling on Twitter, most Tennessee Republicans were notably silent.
According to the Kaiser Family Foundation, 32 percent or 1.26 million Tennessee non-elderly adults have preexisting health conditions.
The Bristol-Kingsport-Johnson City area in Upper East Tennessee has the highest rate of of adults age 18-64 with pre-existing conditions in the entire country at 41 percent, according to Kaiser.
Nationally, the figure is 52.2 million, or 27 percent of adults age 18-64.
Figures for the Chattanooga area weren't immediately available. Hamilton County does have among the highest numbers of residents enrolled among Tennessee counties in the ACA federal marketplace with 14,250 people.
Jacy Warrell, executive director of the Tennessee Health Care Campaign, said O'Connor's ruling "puts the health security of Tennesseans at risk," adding that "we are especially disappointed at Tennessee's own Attorney General Herbert Slatery's involvement in this lawsuit."
He noted among the ACA's protections are barring insurance companies from charging women or older adults more for the same policy than men and younger adults.
Dr. Thomas Phelps, a Tullahoma physician who works with the Protect My Care organization, asked what Alexander has to say about the ruling. "Despite voting to repeal and replace the ACA last year, he at one time had enough sense to know that it was wrong to completely do away with the health law without a plan in place."
Alexander once said he supported passing a "repeal and replace" plan, noting, "I don't think Tennesseans would be comfortable canceling insurance for 22 million Americans, and trusting Congress to find a replacement in two years. Pilots like to know where they're going to land when they take off, and we should too."
"Is this ruling not exactly what Sen. Alexander once feared?" Phelps asked. "I'd like to know whether he's off celebrating like President Trump or if he's doing the right thing by urging Attorney General Slatery to withdraw Tennessee from this disaster of a court case."
Contact Andy Sher at asher@timesfreepress.com or 615-255-0550. Follow him on Twitter @AndySher1.