a 64-page opinion.

Federal court expresses concern over health care reform law

The opinion is the first of three rulings that will emerge from federal appeals courts around the country in the coming weeks over the Patient Protection and Affordable Care Act.

The issue is almost certain to eventually reach the Supreme Court, perhaps by year's end. More than two dozen other legal challenges to the law are floating in lower federal courts.

Toobin: Fight over health care law will end up at Supreme Court

The health care reform act was passed by the Democratic Congress last year, and championed by President Barack Obama.

A key part of the ruling was written by Judge Jeffrey Sutton, a President George W. Bush appointee and considered a conservative on the court. He said the health carePresident Jimmy Carter. He turned aside the argument by opponents of the law that economic "inactivity" cannot be regulated by the national legislature.

"Congress had a rational basis for concluding that the minimum coverage provision is essential to the Affordable Care Act's larger reforms to the national markets in health care delivery and health insurance," he said. "The provision regulates active participation in the health care market, and in any case, the Constitution imposes no categorical bar on regulating inactivity."

Judge James Graham -- a Reagan appointee -- agreed with most of the opinion but expressed some concern that Congress could go too far in other economic arenas, under limits imposed by the Constitution's commerce and spending clauses.

"If the exercise of power is allowed and the mandate upheld, it is