(Bloomberg) -- The U.S. Supreme Court refused to take up a new constitutional challenge to Obamacare, turning away an appeal that said lawmakers used flawed legislative procedures to pass the measure.

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

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

In declining to hear that contention, the high court all but ensured that the Patient Protection and Affordable Care Act, or Obamacare, will remain intact through the November election.

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

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

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

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

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

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

Sissel’s lawyers said Obamacare qualified as a revenue- raising bill, in part, because of the 2012 Supreme Court decision interpreting the law as imposing a tax on people who forgo health insurance.

The three-judge panel rejected that argument, saying that under past Supreme Court cases, the origination clause applies only when a law’s “primary purpose” is to raise revenue. Judge Judith Rogers said money collected by the government was a “byproduct” of the law’s effort to encourage participation in the health insurance system.

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

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

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

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

Instant Insights /

PPACA intact as U.S. Supreme Court rejects appeal

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