(Bloomberg) -- The U.S. Supreme Court refused to take up a newconstitutional challenge to Obamacare, turning away an appeal thatsaid lawmakers used flawed legislative procedures to pass themeasure.

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Opponents of President Barack Obama’s health-care law were seeking to sway acourt that has upheld core parts of the measure twice since 2012,most recently in June.

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In the latest case, they argued that the law violated theconstitutional requirement that revenue-raising legislation startin the House before proceeding to the Senate.

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In declining to hear that contention, the high court all butensured that the Patient Protection and Affordable CareAct, or Obamacare, will remain intact through theNovember election.

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The rebuff leaves health care as one of the core issues in thepresidential and congressional campaigns.

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The latest challenge was pressed by the Pacific LegalFoundation, an advocacy group based in Sacramento, California, onbehalf of Matt Sissel, an Iowa artist and small-business owner.

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The suit had gained little traction in the lower courts, even asit provoked a party-line divide on the legal reasoning.

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A federal trial judge in Washington upheld the law, as did aunanimous panel of three Democratic-appointed judges.

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A larger panel of judges then voted not to reconsider the case.Although the four Republican appointees on the 11-member Washingtonappeals court would have heard arguments, they also said they wouldhave upheld the law for different reasons.

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At issue was a rarely invoked constitutional provision known asthe origination clause, which says that “all bills raising revenueshall originate in the House of Representatives.”

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Sissel’s lawyers said Obamacare qualified as a revenue- raisingbill, in part, because of the 2012 Supreme Court decisioninterpreting the law as imposing a tax on people who forgo healthinsurance.

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The three-judge panel rejected that argument, saying that underpast Supreme Court cases, the origination clause applies only whena law’s “primary purpose” is to raise revenue. Judge Judith Rogerssaid money collected by the government was a “byproduct” of thelaw’s effort to encourage participation in the health insurancesystem.

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The four Republican appointees, led by Judge Brett Kavanaugh,called that conclusion “untenable,” saying the measure would raisealmost $500 billion over 10 years.

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Kavanaugh said, however, that the law had met the requirementthat it originate in the House. When the Senate took up the issuein 2009, it started with a House bill on an unrelated matter andsubstituted what became the core of Obamacare. The House thenapproved it, and Obama signed the measure into law.

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“Congress’s longstanding practice has been to permit Senateamendments of exactly the kind at issue here,” Kavanaugh said.

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The case is Sissel v. Department of Health and Human Services,15-543.

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