Reporting from Washington — A federal judge in Florida dealt President Obama's healthcare overhaul another legal blow Monday, ruling that the entire law is unconstitutional because of a requirement in the legislation that Americans get health insurance starting in 2014.
U.S. District Judge Roger Vinson's widely anticipated decision goes beyond a separate ruling by a federal judge in Virginia who last year ruled only that the insurance mandate is unconstitutional.
DOCUMENTS: Read Judge Vinson's summary judgment
In separate lawsuits, two other federal courts have ruled that the law and its insurance mandate are permissible under the so-called Commerce Clause of the Constitution.
The divided opinions set the stage for a potentially landmark constitutional debate in the higher courts, with a final decision expected in the U.S. Supreme Court, perhaps as soon as next year.
Vinson, an appointee of President Reagan, signaled for months that he would back the challenge to the law filed by Florida's Republican attorney general and joined by 25 other states.
And in his ruling Monday, he said he had no choice but to invalidate the law.
"The existing problems in our national health care system are recognized by everyone in this case," Vinson wrote in the 78-page ruling. "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. … I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate."
Vinson rejected a second claim by the states that the healthcare overhaul unlawfully forced them to expand their Medicaid insurance programs for the poor, another key part of the new law.
And he declined to stop implementation of the law, as the plaintiffs requested.
Vinson's decision comes six weeks after a similar ruling in December by a federal judge in Virginia, who backed a lawsuit by that state's attorney general. U.S. District Judge Henry Hudson, a Republican, also concluded the insurance mandate was unconstitutional, though he declined to halt implementation of the law while higher courts considered the case.
The U.S. 4th Fourth Circuit Court of Appeals in Richmond, Va., has agreed to expedite its review of the Virginia case, scheduling hearings for May.
Other federal judges in Michigan and Florida — both appointed by President Clinton — have concluded that Congress had the authoruty to require Americans to get health insurance.
With some exceptions, the unprecedented insurance mandate will require Americans to get health insurance and penalize those who do not.
The requirement was designed to spread risk more broadly and control insurance premiums, enabling the federal government to offer consumers other protections, such as prohibiting insurers from denying coverage to patients with preexisting medical conditions.
Without a mandate, healthy Americans would be able to avoid buying insurance until they got sick. That phenomenon, which has occurred in several states that have guaranteed coverage without any insurance requirement, has helped drive up premiums.
But the mandate remains the most unpopular feature of the healthcare overhaul and has helped galvanize a nationwide Republican attack on the new law.
Nineteen states joined the Florida suit last year: Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington.
And in January, six more states joined the lawsuit after new GOP governors took office — Ohio, Kansas, Wyoming, Wisconsin, Maine and Iowa.
Except for Louisiana, the states are represented by Republican attorneys general or governors.
The National Federation of Independent Business, a leading conservative small-business group, also joined the suit.
Several dozen leading consumer groups, medical associations and patient advocates have joined the Obama administration in defending the new law.
These include: the American Cancer Society Cancer Action Network, the American Diabetes Assn., the American Heart Assn., the American Nurses Assn., the American Medical Assn., the American Hospital Assn., the Catholic Health Assn. of the United States, the National Breast Cancer Coalition, Families USA, Consumers Union and the March of Dimes Foundation.