Earlier this week, Senior United States District Judge Roger Vinson of the United States District Court for the Northern District of Florida declared the Patient Protection and Affordable Care Act (the “Act”) void in a summary judgment decision in the case of State of Florida, by and through Attorney General Pam Bondi, et al. v. United States Department of Health and Human Services, et al.

The plaintiffs in the case are the Attorneys General and/or Governors of 26 states (the “State Plaintiffs”), two private citizens, and the National Federation of Independent Business (collectively, the “Plaintiffs”). The State Plaintiffs allege that the Act violates the Spending Clause of the Constitution because the mandated expansion of the Medicaid program pursuant to the Act will make the Medicaid program unaffordable for states. The states, however, will be forced to abide by such mandate because their health systems will fail without federal funds. The Plaintiffs allege that the requirement that all citizens purchase federally approved health insurance or pay a monetary penalty beginning in 2014 (the “Individual Mandate”) is unconstitutional because it exceeds the powers of the federal government set forth in the Commerce Clause of the Constitution. The Plaintiffs argue that the Commerce Clause only regulates “activity” and an individual’s failure to purchase health insurance is by its definition “inactivity.” In regulating “inactivity,” the federal government has exceeded its constitutional authority granted by the Constitution.

In the decision, Judge Vinson dismissed the State Plaintiffs’ claim that the Act violates the Spending Clause. Judge Vinson concluded that the State Plaintiffs need not comply with the Medicaid program expansion mandates and can opt out of the Medicaid program, even though this may be a difficult choice. The judge, however, held that the Individual Mandate exceeds the powers of the federal government set forth in the Commerce Clause of the Constitution. He examined the Supreme Court’s application of the Commerce Clause in previous opinions and concluded that the Commerce Clause has been interpreted to apply to different “activities” having a substantial relationship to, or substantially affecting, interstate commerce. Judge Vinson stated, “It would be a radical departure from existing case law to hold that Congress can regulate inactivity under the Commerce Clause. If [Congress] has the power to compel an otherwise passive individual into a commercial transaction with a third party merely by asserting --- as was done in the Act --- that compelling the actual transaction is itself “commercial and economic in nature, and substantially affects interstate commerce” [see Act § 1501(a)(1)], it is not hyperbolizing to suggest that Congress could do almost anything it wanted.”

Finally, Judge Vinson stated “it is reasonably evident….that the Individual Mandate was an essential and indispensable part of the health reform efforts, and that Congress did not believe other parts of the Act could (or it would want them to) survive independently.” As such, Judge Vinson held that Individual Mandate could not be severed from the Act and declared the entire Act void. The U.S. Department of Justice stated that it will appeal the ruling.

Three other United States District Courts have ruled on the constitutionality of the Individual Mandate (see, Liberty Univ., Inc. v. Geithner, F. Supp. 2d (W.D. Va. Nov. 30, 2010); Thomas More Law Center v. Obama, 720 F. Supp. 2d 882 (E.D. Mich. 2010) and Virginia v. Sebelius, 728 F. Supp. 2d 768 (E.D. Va. 2010)). Two of the cases upheld the constitutionality of the Individual Mandate and one held that the Individual Mandate unconstitutional. As conflicting decisions continue to be issued on the constitutionality of the Individual Mandate, it is likely that the Supreme Court will take up the issue.