WASHINGTON –– The health reform law passed last year faces continuing challenges in the courts, Congress and at the administrative level within the federal government.

In a lawsuit involving 26 states, U.S. District Judge Roger Vinson threw out the entire Patient Protection and Affordable Care Act as unconstitutional because of the section requiring all Americans to have health insurance by 2014 or face government penalties.

“I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the act with the individual mandate,” Vinson wrote in a 78-page opinion. “That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system. … The principal dispute has been about how Congress chose to exercise that power here.”

The Florida judge’s Jan. 31 ruling followed a December decision by a federal judge in Virginia that the individual mandate was an unconstitutional expansion of government power.

The law appears headed ultimately to the U.S. Supreme Court for a decision. Two other judges had earlier ruled that the individual mandate was constitutional.

But the president and CEO of the Catholic Health Association believes the law will ultimately be affirmed and “we will all benefit” from the law by bringing 32 million uninsured American under the health insurance umbrella and making other improvements in the U.S. health system through provisions of the law.

Sr. Carol Keehan, a Daughter of Charity who was one of the staunchest supporters of the health reform law, acknowledged in a Feb. 3 telephone interview with Catholic News Service that the law still faces “some pretty significant journeys before it is all settled.”

CHA joined with other hospital and physician groups in January in a friend-of-the-court brief defending the health reform law in a Michigan case.

“All Americans – insured and uninsured alike – make use of the health care system, thus accruing health care costs,” said the brief in defending the individual mandate. “Given this reality, all individuals must make a decision as to how to finance these costs.”

The brief also says the law does not force people to buy health care but rather “is a mere financing mechanism for another activity that they already undertake: consumption of health care. Congress did not make people obtain that underlying product in new or different quantities, and this case does not present the question whether Congress could do so. Instead, Congress made sure people pay for what they get.”

In Congress, where the Senate voted 51-47 Feb. 2 against a Republican-led effort to repeal the health reform bill, Rep. Cathy McMorris Rodgers, R-Wash., and vice chairwoman of the House Republican Conference, introduced legislation in the House to block the Internal Revenue Service from hiring new employees to enforce the individual mandate. The House had voted to repeal the health reform law Jan. 19.

Meanwhile, the Institute of Medicine’s Committee on Preventive Services for Women – charged with making recommendations to the Department of Health and Human Services about what should be included among mandated preventive services for women under the new law – scheduled its third and final meeting for March 9 in Washington.

At its first meeting in November, the pro-life spokeswoman for the U.S. Conference of Catholic Bishops urged the committee not to include contraception or sterilization among the mandated services.

“To prevent pregnancy is not to prevent a disease – indeed, contraception and sterilization pose their own unique and serious health risks to women and adolescents,” said Deirdre McQuade, assistant director for policy and communications at the U.S. bishops’ Secretariat of Pro-Life Activities.

HHS is expected to issue its list of preventive services that every health plan is required to cover under the new law by Aug. 1.