Would The Supreme Court Reject The Affordable Care Act?

A Florida federal judge ruled Monday that Congress overstepped its authority when it passed last year's Affordable Care Act, providing the most serious challenge yet to President Obama's signature legislative accomplishment. Attorneys for the 26 states that brought the suit said Monday that the decision gives those states grounds to ignore the law, though the Obama Administration disagrees and has vowed to appeal. The latest salvos all but guarantee that the Supreme Court will step in to decide whether the law is constitutional, now that two federal judges have ruled in favor of the legislation and, counting the Florida decision, two have ruled against it.

But as those challenges snake their way up through the courts, more than just health care reform is at stake. If successful, the suits could end up rejiggering the delicate balance between the federal government and the states, and could profoundly redefine the limits of congressional power. (See 10 players in health care reform.)

The legislation at issue, and in particular its requirement that all Americans buy health insurance, is rooted in the power granted to Congress by the commerce clause of the Constitution. That's the bit of language in Article I that says Congress has the power to "regulate commerce with foreign nations, and among the several states, and with the Indian tribes."

For most of the past 100 years, the Supreme Court has interpreted those few words broadly, using them to uphold some of Congress's most progressive pieces of legislation, from Depression-era farm quotas to bans on racial discrimination in the 1960s. But when Senate Democrats included the so-called individual mandate in the health care reform bill last year, some Republicans objected immediately, arguing that the law simply exceeds Congress's authority.

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