A federal judge in Florida ruled Monday that President Obama's entire health care overhaul law is unconstitutional, placing even noncontroversial provisions under a cloud in a broad challenge that seems certain to be resolved only by the Supreme Court.
Faced with a major legal setback, the White House called the ruling by U.S. District Judge Roger Vinson -- in a challenge to the law by 26 of the nation's 50 states -- "a plain case of judicial overreaching." That echoed language the judge used to describe the law as an example of Congress overstepping its authority. The ruling produced an even split in federal court decisions so far on the health care law, mirroring enduring divisions among the public. Two judges had previously upheld the law, both Democratic appointees. A Republican appointee in Virginia had ruled against it.
The Justice Department announced it would appeal the latest ruling, and administration officials declared that for now the federal government and the states would proceed without interruption to carry out the law. It seemed evident that only the U.S. Supreme Court could deliver a final verdict on Obama's historic expansion of health insurance coverage.
On Capitol Hill, Republican opponents of the law pledged to redouble pressure for a repeal vote in the Democratic-controlled Senate following House action Jan. 19. Nearly all of the states that brought suit in Vinson's court have GOP attorneys general or governors.
Vinson ruled against the overhaul on grounds that Congress exceeded its authority by requiring nearly all Americans to carry health insurance, an idea dating back to Republican proposals from the 1990s but now almost universally rejected by conservatives.
His ruling followed the same general reasoning as one last year by the federal judge in Virginia.
But while the first judge's ruling would strike down the insurance requirement and leave the rest of the law in place, Vinson took it much farther, invalidating provisions that range from Medicare discounts for seniors with high prescription costs to a change that allows adult children up to age 26 to remain on their parents' coverage.
The central issue remains the constitutionality of the law's core requirement that Americans carry health insurance except in cases of financial hardship. Starting in 2014, those who cannot show they are covered by an employer, government program or their own policy will face fines from the IRS.
Opponents say a federal requirement that individuals obtain a specific service -- a costly one in the case of health insurance -- is unprecedented and oversteps the authority the Constitution gives Congress to regulate interstate commerce.
Vinson agreed that lawmakers lack the power to penalize citizens for not doing something. He compared the provision to requiring people to eat healthful food.
"Congress could require that people buy and consume broccoli at regular intervals," he wrote, "not only because the required purchases will positively impact interstate commerce, but also because people who eat healthier tend to be healthier and are thus more productive and put less of a strain on the health care system."
Defenders of the law said that analogy was flawed. Insurance can't work if people are allowed to opt out until they need medical attention. Premiums collected from many who are healthy pay the cost of care for those who get sick. Since the uninsured can get treated in the emergency room, deciding not to get coverage has consequences for other people who act prudently do buy coverage.
Vinson, who was appointed to the federal bench by President Ronald Reagan in 1983, said in his 78-page ruling that requiring people to buy health insurance marks a break with the nation's founding principles.
"It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place," the judge wrote.