Thursday's hearing before Judge Roger Vinson of the U.S. District Court for the Northern District of Florida, as in the case in Richmond, Virginia, will largely center on whether Congress has the constitutional authority to require virtually all Americans to obtain health insurance or pay a fine.
However, the multi-state case being heard in Florida is one of the few among the two dozen pending legal challenges to the law that also contests its expansion of eligibility requirements for Medicaid, the joint federal-state health insurance program for the poor.
Most experts believe that the health-care law's fate will ultimately be decided by the Supreme Court. But if Vinson rules in the states' favor Thursday, it would even the scorecard of federal district court decisions so far.
Two judges, in Detroit and Lynchburg, Va., both of whom were appointed by Democratic presidents, have upheld the law in cases now before courts of appeal. The judge in the Richmond case, Henry E. Hudson, who was appointed by Republican President George W. Bush, was the first to void part of the law, ruling that its insurance requirement exceeded Congress's constitutional authority.
Vinson, also a Republican appointee - he was nominated by President Ronald Reagan - has already signaled that he might be willing to rule at least partly for the states.
In an October decision allowing the case to move forward, he sternly rejected the Obama administration's assertion that the law's penalty for being uninsured amounts to a tax, which the Constitution gives Congress broad powers to levy.
Instead, Vinson has limited Thursday's hearing to the question of whether Congress has the right to impose the insurance requirement as a result of its constitutional authority to regulate activities affecting interstate commerce and to enact laws "necessary and proper" for carrying out that power.
The states - joined in the suit by two individuals and the National Federation of Independent Business, which represents small companies - claim that failing to buy insurance is not an activity, but rather a form of inactivity that must lie beyond the scope of government regulation under the commerce clause.