Judge Rules Health Care Law Is Unconstitutional

stethoscope and pen resting on a sheet of medical lab test results, with patient file and x-ray or mri film (Michael McCloskey 2007)

A U.S. district judge on Monday threw out the nation's health care law, declaring it unconstitutional because it violates the Commerce Clause and surely reviving a feud among competing philosophies about the role of government.

Judge Roger Vinson, in Pensacola, Fla., ruled that as a result of the unconstitutionality of the "individual mandate" that requires people to buy insurance, the entire law must be declared void.

"I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the act with the individual mandate. That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system. The health care market is more than one-sixth of the national economy, and without doubt Congress has the power to reform and regulate this market. That has not been disputed in this case. The principal dispute
has been about how Congress chose to exercise that power here," Vinson wrote.

"While the individual mandate was clearly 'necessary and essential' to the act as drafted, it is not 'necessary and essential' to health care reform in general," he continued. "Because the individual mandate is unconstitutional and not severable, the entire act must be declared void."

Department of Justice spokeswoman Tracy Schmaler said the department plans to appeal Vinson's ruling to the 11th Circuit Court of Appeals.

“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," she said. "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.

"We are analyzing this opinion to determine what steps, if any -- including seeking a stay -- are necessary while the appeal is pending to continue our progress toward ensuring that Americans do not lose out on the important protections this law provides, that the millions of children and adults who depend on Medicaid programs receive the care the law requires, and that the millions of seniors on Medicare receive the benefits they need," she added.

The case is undoubtedly headed to the Supreme Court. But for now, opponents of President Obama's signature domestic legislation exalted while supporters denounced the decision.

"I applaud the ruling today by Judge Vinson," said Florida Gov. Rick Scott, who, prior to getting elected in November, helped lead the charge against the law.  "In making his ruling, the judge has confirmed what many of us knew from the start -- ObamaCare is an unprecedented and unconstitutional infringement on the liberty of the American people. ...  Patients should have more control over health care decisions than a federal government that is spending money faster than it can be printed."

"Judge Vinson's decision is radical judicial activism run amok, and it will undoubtedly be reversed on appeal. The decision flies in the face of three other decisions, contradicts decades of legal precedent, and could jeopardize families' health care security," said Ron Pollack, executive director of Families USA.  "If this decision were allowed to stand, it would have devastating consequences for America's families."

Vinson's decision, while surprising, was not unforeseen. In October, the judge dismissed four of the six counts in the suit led by then-Florida Attorney General Bill McCollum and joined by 25 other states. But he allowed two counts, including one challenging the law's controversial requirement that Americans buy health insurance, to proceed. Arguments were heard in December.

In his earlier ruling, Vinson said that a government report called the requirement to buy insurance legally unprecedented and worth examining in court.

"The individual mandate applies across the board. People have no choice and there is no way to avoid it. Those who fall under the individual mandate either comply with it, or they are penalized. It is not based on an activity that they make the choice to undertake. Rather, it is based solely on citizenship and on being alive," he wrote.

Nearly two dozen suits have been filed in federal courts, but Monday's ruling is the biggest judicial decision to come down the pike since Congress last March passed the bill aimed at covering 30 million uninsured Americans whether they want insurance or not.

In other cases, a federal district judge in Richmond, Va., ruled the individual mandate is unconstitutional but left standing other parts of the law. In Michigan, the argument concerning the "individual mandate" -- the central tenet that requires Americans to start buying health insurance in 2014 or pay a penalty -- was thrown out by another federal judge.

"That judge, under his mindset, said basically if someone thought that I were overweight, if they rule this way, the federal government would be able to mandate that I go down to the Gold's Gym and fill out an application and contract with Gold's Gym to lose weight and lower my cholesterol," said South Carolina Attorney General Alan Wilson, whose state is among the parties filing the multi-state suit. "That is the kind of logic that we're going to right now where you're actually telling people that they have to engage in an activity and that is simply too broad a policy for the federal government."

Last week, the U.S. House of Representatives passed a repeal of the 10-year, $1 trillion plan that critics say will cost closer to $2.6 trillion. But the repeal bill will likely die in the Senate, meaning Vinson's ruling is the newest grounds on which supporters and opponents proceed.

Defenders of the law say that Americans need to be covered from ruthless insurance companies that either refuse to insure children with illnesses and adults with pre-existing conditions or charge exorbitant amounts for individual coverage. The law aims to provide a federal umbrella under which Americans can purchase and keep insurance regardless of their health, career changes or ability to pay.

But Vinson said that is not the U.S. government's job.

"Regardless of how laudable its attempts may have been to accomplish these goals in passing the act, Congress must operate within the bounds established by the Constitution. Again, this case is not about whether the act is wise or unwise legislation. It is about the constitutional role of the federal government," he wrote.

Supporters of the law also note that Congressional Budget Office figures that show if repealed, government deficits will climb by $230 billion over the next 10 years.

Critics counter with a "junk in, junk out" description of the CBO's estimates, claiming the numbers used to reach the conclusions are bogus and based on best-case scenarios that don't realize additional spending and unlikely savings, particularly as the law, in the first decade, collects taxes for 10 years though it only pays for six years of coverage and relies on money to be collected for a separate health program -- Medicare.

In his State of the Union address, Obama said he was willing to open his mind to changes in the law if they made dollars and sense and didn't prevent patients with pre-existing conditions or other barriers to insurance companies from gaining coverage.

He pointed to the near-universally hated 1099 provision that orders businesses to report to the Internal Revenue Service all purchases exceeding $600 as the first provision to be scrapped.

Obama Chief of Staff Bill Daley repeated the president's position on Sunday, adding that the law was intended to help employers as much as patients.

"The president has said he's open to changes to this. He is not open to re-fighting the entire fight of health care," Daley told CBS' "Face the Nation."

"I absolutely believe, having been in business and hearing from business people, the importance of a need for the reform of health care. It was the business community that was really saying to the politicians, this is costing us too much, it's too much of a wet blanket on the economy," he said.