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An appeals court judge appointed by President Ronald Reagan just wrote an opinion affirming the constitutionality of the federal law overhauling health care.
That makes three appeals court decisions in favor of the law and one against, if you're keeping track.
But the latest decision written by Judge Laurence Silberman of the U.S. Court of Appeals for the District of Columbia, could shift the prospects for challenges against the law, which are expected to reach the Supreme Court within months.
"If someone like Judge Silberman, who is among the most conservative judges in the country, is willing to say that this case has no merit, I think it's a very very good sign that some of the conservative justices on the Supreme Court are going to break ranks as well," Ian Millhiser, a policy analyst at the liberal think tank Center for American Progress, told NPR.
The 2-1 ruling by the court affirms the health insurance mandate at the core of law, finding that it's consistent with Congress' constitutional authority to regulate interstate commerce.
Starting in 2014, most Americans will have to show they have health insurance coverage or pay a financial penalty.
Judge Harry Edwards, appointed by President Carter, voted with Silberman to uphold the law. Judge Brett Kavanaugh, appointed by President George W. Bush, dissented, saying the court couldn't rule on a tax-related issue (the penalty for a lack of insurance would be levied along with federal taxes) until the tax had been collected.
Silberman's opinion acknowledged that "a direct requirement for most Americans to purchase any product or service seems an intrusive exercise of legislative power" and explains why legislators hadn't gone that route before.
While a mandate "certainly is an encroachment on individual liberty," he continues, it's no more intrusive than requiring hotels and restaurants to serve customers without regard for race.
"The right to be free from federal regulation is not absolute, and yields to the imperative that Congress be free to forge national solutions to national problems, no matter how local — or seemingly passive — their individual origins," the decisions concludes.