U.S. District Court Judge Roger Vinson in Pensacola, Florida, declared the entire Patient Protection and Affordable Care Act void because its key provision—the individual mandate to buy health insurance—is unconstitutional.
In a 78-page ruling issued Jan. 31, Vinson ruled that Congress, which aimed to give 32 million more Americans health care insurance by 2019 through the reform law, exceeded its constitutional authority by threatening Americans with fines if they don’t buy health insurance. He declined the argument by states objecting to the law that Congress exceeded its authority by forcing states to expand their Medicaid programs.
Vinson concluded, however, that the individual mandate is inextricable from the rest of the law and thus the entire law is void.
“The individual mandate is indisputably necessary to the act’s insurance market reforms, which are, in turn, indisputably necessary to the purpose of the act,” Vinson wrote in the opinion. “Because the individual mandate is unconstitutional and not severable, the entire act must be declared void. This has been a difficult decision to reach, and I am aware that it will have indeterminable implications.”
Although Vinson is the fourth judge to rule on the reform law’s constitutionality, the Pensacola case has been the most closely watched because it features as plaintiffs 26 states with Republican governors or attorneys general. The Democratic-led Congress passed the law last March without a single GOP member voting in favor in either chamber.
Vinson is the second judge to strike down portions of the law on constitutional grounds, following another Republican-appointed judge who ruled similarly last month in Richmond, Virginia. Democratic-appointed Judges in Detroit and Lynchburg, Virginia, have already ruled in favor of the law, prompting critics and proponents alike to predict that the law’s fate will ultimately be decided by the Supreme Court.
The law’s proponents say the mandate to purchase private insurance, effective in 2014, is necessary because the reform law also bars insurers from rejecting customers with pre-existing conditions or costly lifetime medical bills. The expansion of Medicaid, which is expected to account for about half of the newly insured, will be funded by the federal government until 2019, after which states will have to pick up a percentage of the expanded cost.
Vinson said the law will remain in effect until all appeals are exhausted.