The individual mandate provision of the Patient Protection and Affordable Care Act has again been declared unconstitutional, this time by the U.S. Court of Appeals for the 11th Circuit in Atlanta, Georgia.
This is the first time a Democratic-appointed judge has voted against the mandate.
Ultimately, the decision on any requirement that every American must purchase health coverage will be decided by the U.S. Supreme Court.
The 11th Circuit decision is the second time a federal appellate court has ruled, but the first time one has stricken it down. In June, Court of Appeals for the Sixth Circuit in Cincinnati upheld the mandate.
The Atlanta court's 304-page opinion sided with a Florida federal district court, which said an individual mandate is not authorized under laws allowing the federal government to regulate interstate commerce.
While Friday's decision is a blow to the Obama administration, the Atlanta court said in a 2-1 vote that the rest of the healthcare reform law could stand.
Challenges against the act have been filed in various courts in 26 states.
Robert Zirkelbach, spokesman for the America's Health Insurance Plans gave this response:
"Throughout the health care reform debate there was broad agreement that enacting guarantee issue and community rating would cause significant disruption and skyrocketing costs unless all Americans have coverage.
"States that have implemented these laws without covering everyone have seen a rise in insurance premiums, a reduction of individual insurance enrollment and no significant decrease in the number of uninsured."