A Federal judge in Virginia has ruled that a central tenant of the Patient Protection and Affordable Care Act is unconstitutional. Judge Henry Hudson deemed that the Minimal Essential Care Coverage provision, which mandates that most Americans carry health insurance starting in 2014, oversteps “the constitutional boundaries” of the commerce clause. “The unchecked expansion of congressional power to the limits suggested by the Minimum Essential Coverage Provision would invite unbridled exercise of federal police powers,” Hudson’s ruling states. "At its core, this dispute is not simply about regulating the business of insurance - or crafting a scheme of universal health insurance coverage – it’s about an individual's right to choose to participate."

While Hudson, a Republican appointed to the bench by President George W. Bush, declined a request from the lead plaintiff, Virginia Atty. Gen. Ken Cuccinelli, to block implementation of the law while higher courts review the case, the ruling is seen as a significant blow to the law.

The insurance industry pushed for inclusion of a personal mandate to offset the pending restrictions on medical underwriting. The argument advanced was that in the absence of a mandate to buy insurance individuals would wait until they were ill before purchasing coverage. 

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