UPDATE: The Justice Department has announced plans [4] to appeal to the Eleventh Circuit, and said it is considering whether to seek a stay during the appeal process.
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A federal judge in Florida, in the most sweeping decision yet in the constitutional controversy over the new federal health care law, on Monday struck down [5] the entire law. After first ruling that Congress did not have power to require that virtually everyone have health insurance, Senior U.S. District Judge Roger Vinson of Pensacola decided that Congress would not have enacted any part of it without that provision so the law as a whole cannot stand. (The final order is here [6].)
If the ruling were to survive an inevitable appeal by the Obama Administration, Judge Vinson would have brought about the same practical result that the new Republican majority in the House had hoped to achieve by voting last month to repeal the entire measure. But that repeal measure would not be likely to be passed by the Senate, so the courts — and ultimately the Supreme Court — may have the last word.
Here is one of the crucial parts of the judge’s reasoning for nullifying all parts of the 2,700-page law: “In the final analysis, this Act has been analogized to a finely crafted watch, and that seems to fit. It has approximately 450 separate pieces, but one essential piece (the individual mandate) is defective and must be removed. It cannot function as originally designed. There are simply too many moving parts in the Act and too many provisions dependent (directly and indirectly) on the individual mandate and other health insurance provisions — which, as noted, were the chief engines that drove the entire legislative effort — for me to try and dissect out the proper from the improper, and the able-to-stand-alone from the unable-to-stand-alone. Such a quasi-legislative undertaking would be particularly inappropriate in light of the fact that any statute that might conceivably be left over after this analysis is complete would plainly not serve Congress’ main purpose and primary objective in passing the Act.”
The judge concluded that Congress wrote the law primarily to change the health insurance industry, and not to deal with health care delivery across the board. Even President Obama, Vinson said, had referred to this law as a health insurance program.
The jurist, in his 78-page opinion, did not dispute that Congress has the authority to make major changes in the health insurance market, so his ruling does not take that option off the legislative table. But in analyzing Congress”s authority to regulate commerce among the states, the judge concluded that that power does not extend to a requirement that, with very few exceptions, every individual in the U.S. must obtain health insurance by the year 2014.
In a very lengthy discussion of the history of the Commerce Clause and the Supreme Court’s interpretations of it from as early as 1829, the judge drew two conclusions about the insurance-purchase mandate.
First, he ruled that Congress’s authority to pass laws regulating interstate commerce is limited to economic “activity.” Second, he ruled that a private decision not to buy health insurance was “inactivity,” not activity.  Even in the broadest rulings by the Supreme Court in favor of Congress’s Commerce Clause authority, the judge said, some identifiable economic activity was involved
Although defenders of the new law have argued that the Supreme Court had never ruled that Congress”s powers over commerce only related to “activity,” Judge Vinson said that was due to the simple fact that Congress never before had attempted to regulate “inactivity” as it did with the insurance mandate.
The Pensacola judge was the second federal jurist to find the insurance-purchase mandate to be beyond Congress’s authority over interstate commerce. U.S. District Judge Henry E. Hudson of Richmond, Va., did so on Dec. 13; the Hudson decision, in a Virginia case, is now under review by the Fourth Circuit Court in Richmond. (Any appeal of Judge Vinson’s ruling would go to the Eleventh Circuit Court, based in Atlanta.)
Hudson, in his ruling, did not find the entire law to be unconstitutional because of the invalidation of the insurance mandate. He found, in other words, that that mandate could be “severed” from the rest of the Act.  Vinson went further, finding that the two — the mandate and the law in its entirety — could not be separated and still fulfill what Congress had in mind.
The two judges agreed, though, on another issue: both refused requests by the challengers of the law for a binding court order that would bar the government from enforcing the law as found unconstitutional. Both said that the Executive Branch can be trusted to respect the decisions of the courts. So, each decision was, formally, a declaratory judgment ruling — for Hudson, against the mandate, and for Vinson, against all parts of the law.
Vinson, like Hudson, not only rejected the Administration’s Commerce Clause argument for what Congress had done, but also turned aside a separate argument that the mandate or the law could be justified under the Constitution’s Necessary and Proper Clause.   That clause does not provide any sepasrate basis for legislative power; it only allows Congress to choose “proper” means to enforce an existing, specific grant of authority.
Although the new law has been challenged in more than a dozen cases across the country, the case before Judge Vinson was the broadest: it was filed by 26 states, two private individuals, and the National Federation of Independent Business. That lawsuit had challenged several other parts of the law along with the insurance mandate, but Vinson in October had pared it down to two provisions.
Besides the insurance, the case was left with a separate challenge to major overhaul of the Medicare and Medicaid health insurance programs for the elderly and the needy. The states had argued that those changes would bankrupt them. Vinson, in his final ruling, refused to strike down that provision as a separate matter. But, as a result of the ruling against all parts of the law, that section, too, fell.
Also falling were some parts of the law that have already been put into effect by the federal government, and several parts that have gained widespread popularity — including providing insurance coverage for children u p to age 26, on their parents’ policies, and bans on denying health for coverage for individuals with pre-existing medical problems.
There has been some talk in Congress of trying to re-enact some of the more popular features, perhaps in separate pieces of new legislation.