We are beginning to see action (and divergent results) on the various court challenges to PPACA, starting with two recent decisions.
As explained in SSD's Sixth Circuit Blog, the federal court for the Western District of Michigan dismissed the case of Thomas More Law Center, et al. v. Obama (E.D. Mich., Case No. 10-CV-11156) (PDF) that challenged whether Congress has authority under the commerce clause of the U.S. Constitution to mandate the purchase of health insurance and the power to impose tax penalties for failure to buy such insurance. The plaintiff plans to appeal the case to the Sixth Circuit Court of Appeals, making it likely that this case will yield the first appellate decision on PPACA.
A judge in Florida came to the opposite conclusion in a similar case, State of Florida, et al. v. U.S. Dep’t of Health and Human Services, et al. (N.D. Fla., Case No. 3:10-cv-91) (PDF), which is also discussed further by SSD's Sixth Circuit Blog. In the Florida case, the judge denied the federal government's first effort to dismiss the claim that Congress overstepped its authority by passing PPACA, stating that the plaintiffs (twenty state attorneys general) made sufficient allegations to continue with their constitutional claim.
If this split in authority continues through the appeals, these issues may end up before the U.S. Supreme Court.