If the ruling holds up on appeal, Obamacare is dead.
Here’s the short version. Texas and other states sued to declare the individual mandate unconstitutional because in the recent tax reform the penalty for failing to pay the mandate was removed. (2nd Amended Complaint here) With the removal of the mandate penalty, the mandate no longer was a function of Congress’ taxing power, which was the basis upon which John Roberts and the liberal Justices on the Supreme Court upheld the constitutionality of the mandate in 2012. The Court conservative and Roberts had ruled the mandate violated the Commerce Clause, but Roberts broke with the conservatives on the tax power issue.
But there’s more.
The district court ruled that the mandate was an essential and inseverable part of Obamacare. Because the mandate was held to be unconstitutional and inseverable, the judge held the remainder of Obamacare to be unconstitutional.
The Court did not grant an injunction, so the Trump administration is under no obligation to terminate programs under Obamacare unless and until the Order holds up on appeal.