Unlike the earlier case in Virginia, this decision takes effect immediately and applies to the entire law.
A Federal Court in Florida ruled that the Patient Protection and Affordable Care Act, the major federal healthcare reform law, is unconstitutional. Last December, a Federal Court in Virginia ruled that a portion of the Healthcare Law was unconstitutional, but the Federal Court in Florida goes further, first by ruling that the entire Act is unconstitutional, and second by making its decision effective immediately.
The Court determined that the individual mandate provision, also known as the Minimum Essential Coverage Provision, makes the law unconstitutional. This provision requires that every person purchase and maintain a minimum level of health insurance coverage beginning in 2014, and imposes penalties for failing to comply.
Congress is generally given broad latitude to regulate "commerce". The Court ruled that failure to purchase health insurance is not commercial activity – and in fact it is inactivity, which has never been regulated under the Commerce Clause. The Court held that failing to have insurance does not affect the healthcare market; it is the receiving of healthcare services without insurance that affects the market. Thus, it may be constitutional to regulate uninsured people upon their receipt of treatment – but not prior to their treatment.
The Court went on to hold that the Minimum Essential Coverage Provision was an integral part of the legislation and therefore, the invalidation of the individual mandate requires holding the entire law unconstitutional. The Court further refused to stay its decision, so that the declaration of unconstitutionality takes effect immediately. This means that the law cannot be implemented without violating the Court Order.
We expect that the United States Department of Justice will seek to remove the stay imposed by the Declaratory Judgment pending appeal. The issue of the effectiveness of the stay will probably be litigated before the appeal case itself is decided. For now, however, the law mandates, regulations, and coverage requirements have been found unconstitutional in two jurisdictions, and constitutional in three other jurisdictions. The United States Supreme Court recently refused to hear an expedited appeal submitted by the attorney general in Virginia, so it will likely be several years before the conflict in court decisions is finally decided.
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