CHARLESTON, W.Va. — A coalition of states and the Trump administration on Wednesday submitted their arguments against the federal health care law, arguing Congress’ elimination of the law’s tax penalty in 2017 not only made the provision unconstitutional but the entirety of “Obamacare” as well.

The plaintiffs and the federal government said the 5th Circuit Court of Appeals in New Orleans should reaffirm a federal judge’s decision in December striking down the law.

A coalition of states, led by Texas and including West Virginia, launched an effort last year challenging the constitutionality of the Affordable Care Act. While the U.S Department of Justice at first declined to defend the law in court, the department in March came out in support of Judge Reed O’Connor’s decision.

“In the district court, the Department of Justice took the position that the remainder of the ACA was severable, but upon further consideration and review of the district court’s opinion, it is the position of the United States that the balance of the ACA also is inseverable and must be struck down,” Justice Department attorneys said.

O’Connor, whom President George W. Bush appointed, serves on the U.S. District Court for the Northern District of Texas.

“This case is not about whether the ACA is good or bad policy,” the state coalition argued. “It is about the constitutional limits on our federal government and the proper text-based interpretation of statutes. At issue is not what health-insurance system is optimal, but ‘only whether Congress has the power under the Constitution’ to command the people as the ACA does.”

The U.S. Supreme Court ruled in favor of “Obamacare” in 2012, calling the individual mandate an exercise of Congress’ ability to issue a tax. The provision, in which people would be required to purchase health insurance, was removed as part of the Tax Cuts and Jobs Act, which became law in December 2017.

In O’Connor’s ruling, he said the individual mandate was essential to former President Barack Obama’s health care law. The Trump administration noted a similar argument.

“Again, Congress did not provide otherwise when it eliminated the mandate’s penalty, because that alone says nothing about what Congress would have intended if the courts then further set aside the essential ACA elements of the mandate itself and the guaranteed-issue and community-rating provisions,” it said.

A ruling against the health care law would affect more than 20 million Americans with health insurance, including people with pre-existing conditions and young people still on their parents’ insurance plans.

A decision striking down the law would also impact individuals who gained coverage through state Medicaid expansion programs, including 160,000 West Virginians. West Virginia expanded Medicaid in 2014.

President Donald Trump previously said a health care bill will be taken up after the 2020 election cycle, setting up a battle for himself and other Republicans who have fought “Obamacare.”

Sen. Shelley Moore Capito, R-W.Va., who is running for reelection, told MetroNews last month there are provisions of the current law that need to be maintained yet changes are needed.

“If the courts were to strike it down, there wouldn’t be an immediate everybody loses their health care the next day, which is what many people would have you believe because that is frightening to people and rightly so,” she also said. “I think we would have a chance to go in and reshape health care and make it better over a period of time.”

West Virginia Attorney General Patrick Morrisey told MetroNews in March his involvement in the lawsuit stemmed from increasing premiums.

“I believe this should be viewed as opening a debate to get rid of all the parts of ‘Obamacare’ that are highly problematic, and then sit down and have a conversation and say let’s have something that works much better for West Virginia,” he said.

An analysis from the Kaiser Family Foundation found premiums in West Virginia increased by 112% between 2014 and 2019. The U.S. Census Bureau last fall reported the state’s uninsured rate fell from 14% in 2013 to 5.3% in 2016. The rate increased to 6.1% in 2017.

A second coalition of states, led by California, and the U.S. House of Representatives are appealing the December decision, arguing the entire law should stand regardless of the constitutionality of the individual mandate.

“The Trump Administration chose to abandon ship in defending the #ACA and the hundreds of millions of Americans who depend on it for their medical care,” California Attorney General Xavier Becerra tweeted. “Our legal coalition will vigorously defend the law and the Americans President Trump has abandoned.”

Oral arguments in the case are scheduled for July.