Health Care Lawsuits on a Collision Course to Supreme Court

President Obama's national health care law hangs in the balance as two federal court cases testing the constitutionality of the law are racing to completion this month.

Both Florida and Virginia have pending cases in District Court. Florida's lawsuit - which is joined by more than 20 other states and the National Federation of Independent Business - questions the legality of the law as a whole. In the middle of October, a judge there ruled that two of the six counts, those dealing with a requirement in the law to buy insurance and an expansion to Medicaid, could go to trial. A further ruling is expected later this month.

Virginia's case, led by Attorney General Ken Cuccinelli, focuses only on the so-called individual mandate, and whether or not Congress can use its powers stipulated in the Commerce Clause to demand people buy health insurance. The judge in Virginia has indicated that he too is likely to rule before year's end.

After the district court level, cases proceed to the appellate courts. Unlike a car accident or wrongful imprisonment where cases can develop over years of investigation, there's usually no new evidence to be presented at this level, meaning previous rulings are likely to stand, sending both state-based cases on a collision course to the Supreme Court. And only one of those cases is likely to be heard.

Cuccinelli, who's not one to shy away from the spotlight, has floated the idea of actually bypassing the Fourth Circuit U.S. Court of Appeals and immediately petitioning the Supreme Court. The thinking? He could cement his commonwealth's place in history. But court experts say it's highly unlikely the high court would agree to hear the case now. The entire law doesn't go into effect until 2014, thus no real reason to set a precedent of bypassing a lower court.

There are other lawsuits against the Patient Protection and Affordable Care Act making their way through the court system. Another Virginia judge recently rejected a suit brought by Liberty University, and a similar suit was rejected in Michigan in October. In Ohio at the end of November, a judge ruled another suit was allowed to continue in part, focusing only on the individual mandate.

So for now it's a waiting game and all outcomes have the potential to be history in the making.

Lee Ross contributed to this report