Diagnosis: Unconstitutional

A federal court's ruling on Monday declaring parts of federal health care reform unconstitutional elicited plenty of reaction in Texas, which is part of a separate attempt to repeal the new law.

Henry E. Hudson, a federal district judge in Virgina, took issue with a key provision in the law requiring that most Americans obtain health insurance. And though the ruling won't have any effect until the mandate for coverage is implemented in 2014, Texas Attorney General Greg Abbott says it, along with a few cases still to be heard, will help repeal efforts.

"As a result, these cases are going to work their way up through the appellate system," Abbott says. "And I believe almost to a point of certainty that the United State Supreme Court will be taking the case. But that will be a couple of years down the road."

The Virginia ruling is the third to address the constitutionality of the law but the first to find against it. Scot Powe, a professor at the University of Texas School of Law and a Supreme Court historian, says politics — not the merits of the case — have led to the different outcomes.

"The two [rulings] in favor of the law have been issued by Democratic federal district judges. The one against the law was issued by a Republican federal judge," Powe says. "Party affiliation explains everything."

Audio: Ben Philpott's story for KUT News

That's not to say that Powe expects a nonpartisan ruling if the case finally winds up at the U.S. Supreme Court. More and more, Powe says, the high court is deciding cases along political lines: four liberal justices against four conservative justices, with Justice Anthony Kennedy casting the deciding vote. But solely following previous case law, the court would easily vote to uphold the health care law, Powe says.

"On the other hand, the Supreme Court is unlikely to hear a case for another year or so," Powe says. "And it if waits two years, it will be influenced by the 2012 elections."

Texas and 19 other states have their own lawsuit, set to be heard Thursday in a federal courtroom in Florida. Abbott says the suit, in addition to challenging the insurance mandate, also aims to secure a judge's injunction to stop an expansion of Medicaid.

Even with an injunction, the Supreme Court will have the final say. But for now, a ruling from the Florida judge could give Texas lawmakers more flexibility to make changes to its Medicaid and Children's Health Insurance Program — changes that for now, becuase of the new health care law, can't be made without monetary penalties.

"The ruling by the federal court in the Texas lawsuit will definitely come out in the early stages of the next Texas legislative session," Abbott says. "And as a result, the Legislature can evaluate that ruling and make decisions base upon that ruling."