In the 10 months since President Obama signed health care reform into law, suits have been filed across the country challenging the constitutionality of the Affordable Care Act. Thus far, four judges have ruled on the merits of the issue, the latest coming from Florida Federal Judge Roger Vinson declaring the entire act unconstitutional.
Thus far, the two federal judges upholding the law were appointed by a Democrat. The two who ruled against it were appointed by Republicans.
Judges George Caram Steeh and Norman K. Moon, both of whom upheld Obama's health care reforms, were appointed by former President Bill Clinton. Judges Henry Hudson and Roger Vinson, appointed by Republicans George W. Bush and Ronald Reagan respectively, ruled against the health care law.
The central legal argument revolves around the law's requirement for all Americans to buy health insurance by 2014 or face a financial penalty. Supporters of the reforms claim the federal government has the power to enforce the mandate because the Constitution's Commerce Clause gives Congress the authority to regulate interstate commerce. Those who seek to repeal the law claim health insurance is not interstate commerce.
In the first ruling, on Oct. 7, 2010, Steeh, a federal judge who sits in Detroit, said the mandate was legal because those who choose not to buy insurance and failed to pay the out-of-pocket expenses of their care, affected the costs of health care across the country, thereby affecting interstate commerce.
Nearly two months later the law was upheld again in Virginia by Moon. On Nov, 30, 2010, Moon also cited the Commerce Clause as justification for personal mandates. He said the sheer volume of plans purchased would "in the aggregate substantially affect the interstate health care market."
In a different Virginia court the following month, Hudson, a Republican-appointed U.S. district judge, was the first to strike down a key part of the law. Hudson argued that the government cannot force people to buy insurance, saying the personal mandate overstepped the federal government's authority. Hudson ruled that the requirement to buy insurance "exceeds the constitutional boundaries of congressional power," but did not declare the entire law unconstitutional.
Last week, Vinson, whose district is in Florida, took Hudson's ruling a step further by saying the individual mandate was "inextricably linked" to the rest of the act, therefore the law "must stand or fall as a single unit" making Vinson the first judge to declare the entire law unconstitutional. Vinson said it was not within Congress's constitutional power to force all Americans to purchase insurance.
Vinson wrote in his January 31 ruling that if the individual mandate were left intact, it would be no different than if "Congress could require that people buy and consume broccoli at regular intervals 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."
All judgments are currently under appeal and will likely end up in the U.S. Supreme Court.
The Senate is expected to vote later today on whether to repeal the health care law. Repeal is unlikely, however, since Democrats still hold a majority of 53 to 47.