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Federal Judge in Florida Rules Health Care Law Unconstitutional

His decision won't end the legal battle over reform

A federal judge in Florida on Monday ruled President Barack Obama's landmark health care law is unconstitutional because it requires all Americans to purchase health care insurance.

But the law will most probably remain in effect and continue to be implemented as the case works its way through the judicial system.
A Justice Department spokeswoman, Tracy Schmaler said the government plans to appeal to the Eleventh Circuit Court of Appeals and is considering whether to seek a stay of the judge’s order while the appeal is pending.

"We strongly disagree with the court’s ruling today and continue to believe — as other federal courts have found — that the Affordable Care Act is constitutional," Schmaler said in a statement. "There is clear and well-established legal precedent that Congress acted within its constitutional authority in passing this law and we are confident that we will ultimately prevail on appeal."

U.S. District Judge Roger Vinson, who was appointed to the bench by President Ronald Reagan, was the second federal judge to rule against the law. Vinson wrote that because the requirement — to start buying health insurance in 2014 or pay a fee — was unconstitutional, the entire Patient Protection and Affordable Care Act "must be declared void."

"This has been a difficult decision to reach, and I am aware that it will have indeterminable implications," Vinson wrote. "At a time when there is virtually unanimous agreement that health care reform is needed in this country, it is hard to invalidate and strike down" the law.

Governors and attorneys general from 25 states — all but one Republican — had joined Florida and a national business association in seeking the health law's dismissal. The case, Florida v. HHS, is the most prominent of about 20 other challenges to law.

Two other federal judges, appointed by President Bill Clinton, a Democrat, have upheld the health care law.

Federal judges in Lynchburg, Va., and Detroit, had upheld the so-called individual mandate. U.S. District Judge Henry E. Hudson in Virginia had found the individual mandate unconstitutional but said his ruling applied only to that part of the law.

Vinson stressed that he was not ruling on whether the law was wise or unwise legislation. But, "Congress must operate within the bounds established by the Constitution." The individual mandate was outside power under the Commerce Clause, he said, and the requirement could not be separated from the rest of the law.

"I must conclude that the individual mandate and the remaining provisions are all inextricably bound together in purpose and must stand or fall as a single unit," Vinson ruled.

Dozens of groups joined in "friend of the court" briefs in support or against the landmark law. Jane Perkins of the National Health Law Program, which supported the law, said Vinson’s ruling was "extremely disappointing, especially in light of the other rulings that found the individual mandate to be constitutional."

She said a stay would be necessary to keep the law alive during the appeal process.

Nancy LeaMond, AARP executive vice president, said AARP was “deeply disappointed” that the court ruled against the law, “which is helping to ensure every American can get affordable health and long-term care, including discounted prescription drugs in the Medicare doughnut hole, free preventive care and new insurance options for young adults.”

And she added, the fact that the judge voided the law based on the requirement that Americans have health insurance also was a blow because that requirement would open the door for "important insurance market reforms that will make access to coverage a possibility for Americans who are today shut out due to their age, gender or pre-existing conditions.”

Vinson, in his 78-page opinion, noted the law has been compared to a finely crafted watch. "It has approximately 450 separate pieces, but one essential piece [the individual mandate] is defective and must be removed."

The ruling also said that entire law "must be declared void," because the mandate to carry insurance is "not severable" from the rest of the law.

That differed from an earlier ruling against the law by Judge Hudson in Virginia. Judge Hudson found that the individual mandate was unconstitutional, but he said his ruling applied only to the part of the law that established the mandate and any directly dependent provisions that refer to that part. Exactly what that applied to was unclear.

Judge Vinson, of the U.S. District Court for the Northern District of Florida, ruled against the plaintiffs and in favor of the Obama administration on one point, saying that the law's expansion of the Medicaid federal-state insurance program for the poor does not violate the Constitution.

He wrote that states "have little recourse to remaining the very junior partner in this partnership."

Marsha Mercer is a writer based in Alexandria, Va.

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