A federal judge in Florida on Monday became the first to strike down the entire law to overhaul the nation's health-care system, potentially complicating implementation of the statute in the 26 states that brought the suit.
The decision by U.S. District Judge Roger Vinson represents a more sweeping repudiation of the law than the December ruling in a suit brought by Virginia that found the requirement that most Americans purchase health insurance to be unconstitutional.
As the judge ruled in the Virginia case, Vinson held that Congress overstepped its authority by compelling nearly all Americans to be insured or pay a fine. But Vinson went further: Likening the law to "a finely crafted watch" in which "one essential piece is defective and must be removed," he ruled that the insurance mandate cannot be separated from the rest of the statute and therefore the entire law must be voided.
"There are simply too many moving parts . . . for me to try and dissect out . . . the able-to-stand-alone from the unable-to-stand alone," he wrote.
Vinson, however, upheld the law's expansion of Medicaid, the public insurance program for the poor and disabled that is jointly funded by the states and the federal government. He rejected the states' argument that the expansion infringes on their sovereignty.
Still, the decision bolsters Republican efforts to overturn the law through the courts. All but one of the state officials who brought the suit are Republican.
The case is one of 25 challenges that have been filed in federal courts since the law was enacted last March. Four suits have now been decided on their merits - two rulings upholding the law and, with Monday's decision, two finding all or part of it unconstitutional. The law's constitutionality is widely expected to ultimately be settled by the Supreme Court.
Vinson stopped short of granting an injunction, as the plaintiffs requested, to prevent the law from going forward while the case is appealed. He said such a step was unnecessary because of a "long-standing presumption" that the federal government adheres to rulings of this type.
That part of Vinson's ruling triggered an immediate dispute about the practical effects of the opinion.
David Rivkin, a conservative lawyer in Washington who represents the plaintiffs, said that the 26 states that are party to the lawsuit are no longer subject to any of the law's requirements - unless the federal government obtains a stay of Vinson's order from an appeals court. White House officials firmly rejected that view. "Implementation will proceed apace," one senior White House official said in a background briefing for reporters.
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