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Wed Mar 23, 2011 2:58pm EDT - More than half of all states have launched lawsuits challenging the constitutionality of the healthcare reforms signed into law by President Barack Obama a year ago.

Most legal scholars expect one of the suits to reach the U.S. Supreme Court. Individuals, advocacy groups and hospitals have also sued.

Here are details of the current state of legal challenges to the law:

Lawsuits most likely to reach the Supreme Court

In a lawsuit filed by more than half the states and led by Florida, Judge Roger Vinson said the requirement that individuals buy health insurance is unconstitutional.

While Vinson said the entire law "must be declared void" because the requirement is inextricably linked to other parts of law, he recently put his decision on hold pending appeal.

He also ordered the Obama administration to seek a fast-track review of its appeal, which it filed in early March. Even with an expedited hearing, the case could still be with the 11th Circuit for months before a ruling is issued.

Virginia has asked the Supreme Court to hear its challenge to the law, trying to speed up a definitive ruling, but the Obama administration is pressing for the lawsuit to follow the typical appeals process.

A U.S. appeals court will hear oral arguments between May 10 and 13 challenging the recent ruling by U.S. District Judge Henry Hudson that the federal government could not compel a person to buy health insurance. In a twist, both the federal government and the state of Virginia, which filed the suit, appealed Hudson's decision.

Virginia says the judge erred by not throwing out the entire law. Hudson said the penalty charged for not having health insurance is not a tax, shooting down the federal government's argument that it is empowered to levy taxes.

Other rulings 

A U.S. District Court in New Jersey dismissed on December 9 a lawsuit filed by a cardiologist, a patient and a physicians' advocacy organization that had alleged the law violates the U.S. Constitution's Commerce Clause, which allows the federal government to regulate commerce among the states, and also violated the Fifth Amendment.

Another appeal, in a lawsuit filed by Liberty University, the college founded by conservative evangelical leader Jerry Falwell, has also been expedited and will be heard by the Fourth Circuit court in May.

In November, a federal judge ruled the individual mandate and a requirement some employers buy coverage for employees was legal under the Commerce Clause. The judge also said the law did not illegally permit federal funding for abortion.

A California court dismissed a lawsuit, now under appeal at the Ninth Circuit Court, that said the healthcare law violates individual rights, increases taxes and violates physician-patient privileges, along with violating the Commerce Clause.

In November, U.S. District Court Judge David Dowd partially denied and partially granted a motion to dismiss a lawsuit filed by the U.S. Citizen's Association in Ohio.

While he dismissed arguments that the law violates freedom of association, due process and privacy protections, Dowd is considering arguments that the law exceeds federal authority granted by the Commerce Clause.

At least 24 lawsuits have been filed in federal courts by states and private parties.

What is at issue?

States like Virginia have passed, or are considering, legislation declaring the healthcare law cannot be enforced in their states. State legislators in Maine, Montana, Nebraska, Oregon, Texas and Wyoming have introduced bills that establish penalties, including fines and jail time, for any agent seeking to enforce the healthcare law within their states' borders.

The states' main concern is that the law permits the federal government to force people to buy things, in this case requiring that all Americans purchase health insurance or pay a penalty under the "individual mandate."

The federal government counters that everyone will inevitably pay for healthcare, whether through insurance or during an emergency, and that without the individual mandate, premiums will rise.

 If the courts decide the individual mandate is unconstitutional, it is unclear if the mandate can be cut away from the law while leaving the other requirements intact. The states say that without the individual mandate the law is rendered toothless.

Parts of the U.S. Constitution that have come into play are the Commerce Clause, the Supremacy Clause, which makes federal power supreme to states' power, and the 10th Amendment, which leaves to states all powers not explicitly granted to the federal government.

Some of the suits also focus on whether abortions are funded with taxpayer dollars under the law. When Obama lobbied for the bill, he said there would not be a new tax associated with the individual mandate requiring coverage.

The penalty for not having health insurance, though, is collected through tax filings and the federal government argues the fine is indeed a tax it is empowered to levy.

States say the U.S. government does not have the authority to charge the fine and point to the discrepancy between Obama's statements and the U.S. government's arguments.

Sources: Court documents, governors' offices, Pacific Legal Foundation

(Reporting by Lisa Lambert, Jeremy Pelofsky, James Vicini, Donna Smith in Washington, additional reporting by Karen Pierog in Chicago; Editing by Vicki Allen)

© 2010 Thomson Reuters. Click for Restrictions.


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