Lawsuit Challenging|Health Reform Advances

(CN) - A federal judge in Florida allowed 20 states to proceed with a lawsuit challenging the health care reform bill President Obama signed into law in March.

The attorneys general of 16 states and four state governors argued that "the Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty, that all citizens and legal residents have qualifying health-care coverage."

U.S. District Judge Roger Vinson in Pensacola opened his ruling by noting that, regardless of the nation's myriad views on health care reform, "I am only charged with deciding if the Act is Constitutional."

"If it is, the legislation must be upheld -- even if it is a bad law," he wrote in his 65-page ruling. "Conversely, if it is unconstitutional, the legislation must be struck down -- even if it is a good law."

He concluded that the states "have at least stated a plausible claim" that parts of the Patient Protection and Affordable Care Act are unconstitutional.

Vinson determined that the fine imposed on individuals who don't buy insurance is a penalty and not a tax, which can't be challenged under the Anti-Injunction Act.

He sided with the federal government on some issues, including the claim that the law interferes with state sovereignty by forcing states to enroll their employees in federally approved insurance plans or face substantial penalties. Vinson pointed out that if this employer mandate is unconstitutional, federal minimum wage and labor laws "are likewise unconstitutional as applied to the states."

Vinson also agreed with the government that the reform law does not "coerce and commandeer" states into operating health benefit exchanges to avoid having the federal government step in.

But the judge acknowledged that states "are in an extremely difficult situation" when it comes to changes in Medicaid, which the states say will "run [their] budgets off a cliff."

"They either accept the sweeping changes to Medicaid (which they contend will explode their state budgets), or they withdraw from the system entirely (which they allege could leave millions of their poorest and neediest citizens without any medical coverage)," Vinson wrote (parentheses in original).

The judge said this could be considered coercion and commandeering of state decisions.

Turning to the individual mandate for insurance, Vinson said the penalty for those who fail to buy insurance does not constitute an unconstitutional tax or due-process violation. However, he said it might exceed the Commerce Clause by attempting to regulate economic interstate inactivity, rather than activity, as the clause states.

"The power that the individual mandate seeks to harness is simply without prior precedent," he wrote.

"Those who fall under the individual mandate either comply with it, or they are penalized," he added. "It is not based on an activity that they make the choice to undertake. Rather, it is based solely on citizenship and on being alive."

Although Vinson acknowledged that just because something is unprecedented doesn't make it unconstitutional or improper, he said the plaintiffs "have most definitely stated a plausible claim" based on the Commerce Clause.

Vinson is the third federal judge to tackle a lawsuit challenging the newly enacted health care reform bill. A federal judge in Michigan last week upheld the insurance requirement as constitutional, and in August a federal judge in Virginia refused to dismiss a lawsuit filed by state Attorney General Kenneth Cuccinelli II.

The states challenging the reform bill are Alabama, Alaska, Arizona, Colorado, Florida, Georgia, Idaho, Indiana, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, South Dakota, Pennsylvania, South Carolina, Texas, Utah and Washington.

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