A federal judge in Florida became the first to strike down the entire law to overhaul the nation’s health care system Monday, potentially complicating implementation of the statute in the 26 states, including Maine, that brought the suit.

The decision by U.S. District Judge Roger Vinson represents a more sweeping repudiation of the law than the December ruling in a suit brought by Virginia that found the requirement that most Americans buy health insurance to be unconstitutional.

As in the Virginia case, Vinson held that Congress had overstepped its authority by compelling nearly all Americans to be insured or pay a fine. But Vinson went further: Likening the law to “a finely crafted watch” in which “one essential piece is defective and must be removed,” he ruled that the insurance mandate cannot be separated from the rest of the statute, and therefore the entire law must be voided.

“There are simply too many moving parts … for me to try and dissect out … the able-to-stand-alone from the unable-to-stand alone,” he wrote.

However, Vinson upheld the law’s expansion of Medicaid, the public insurance program for the poor and disabled that is jointly funded by the states and federal government. He rejected the states’ argument that the expansion infringes on their sovereignty.

Still, the decision bolsters GOP efforts to overturn the law through the courts. All but one of the state officials who brought the suit are Republicans.

The case is one of 25 challenges that have been filed in federal courts since the law was enacted last March. Four suits have now been decided on their merits – two rulings upholding the law and, with Monday’s decision, two finding all or part of it unconstitutional. The law’s constitutionality is widely expected to be settled ultimately by the U.S. Supreme Court.

Republican Maine Gov. Paul LePage praised the ruling in a written statement Monday.

“When Maine signed on, we stood up against the individual insurance mandate knowing it was unconstitutional,” LePage said. “Here in Maine, we need comprehensive reform to lower job-killing health care costs. More expensive mandates are not the answer.”

Maine officially joined the lawsuit Jan. 20, one day after Attorney General William Schneider asked that the state be added as a plaintiff.

Schneider responded cautiously to the ruling Monday. He was withholding comment until today so he could first read the entire 78-page decision, said Martha Demeritt, his spokeswoman.

Maine supporters of the law said the ruling in Florida was not a big surprise and is not the final word on the issue.

“It still is the law of the land until the Supreme Court decides,” said Greg White, spokesman for Consumers for Affordable Health Care, an Augusta-based advocacy group. “There are still two other court rulings that have held up provisions of the Affordable Care Act. This just evens it up two to two.”

Judge Vinson stopped short of granting an injunction, as the plaintiffs requested, to prevent the law from going forward while the case is appealed. He said such a step was unnecessary because of a “long-standing presumption” that the federal government adheres to rulings of this type. That part of Vinson’s ruling triggered an immediate dispute over the practical effects of the opinion.

David Rivkin, a conservative lawyer in Washington who represents the plaintiffs, said the 26 states that are party to the lawsuit are no longer subject to any of the law’s requirements — unless the federal government obtains a stay of Vinson’s order from an appeals court.

White House officials rejected that view. “Implementation will proceed apace,” one senior White House official said in a background briefing for reporters.

If the plaintiffs prove to be right, the provisions that could be thrown in doubt, at least temporarily, include some that are already in effect, such as one prohibiting states from saving money by tightening their eligibility standards for Medicaid.

The law’s requirement that individuals purchase health insurance — the issue at the center of the lawsuit — does not take effect until 2014. Neither do other important elements of the law, including the requirement that states set up “exchanges,” or marketplaces, through which individuals and small businesses will be able to purchase private insurance with federal subsidies.

“All of that is dead with regard to these 26 states,” Rivkin said.

White House aides refused to discuss the opinion for attribution. But two senior officials, speaking to reporters on condition of anonymity, disparaged the judge’s ruling. One of the officials said, “The analysis on the whole is, to put it charitably, very unconventional.”

Asked by several reporters whether the ruling could give states that oppose the law permission to stop work on putting it into practice, the officials were adamant that it would not. “He is one court,” one of the officials said. “I don’t think you should view this as the opening of the government shutting down implementation.”

The Justice Department immediately said it plans to appeal the decision to the U.S. Court of Appeals for the 11th Circuit.

David Engstrom, a Stanford Law School faculty member, said he did not interpret the opinion as preventing the law from going forward. “The issue that the court has ruled on has been specifically contradicted by two other district courts,” he said. “So, the idea that the Obama administration should somehow stand down from implementing the act, based on a fourth district court, doesn’t have any basis in law.”

 

Press Herald Staff Writer John Richardson contributed to this report.