The state-by-state showdown on health care reform is trudging forward, with a recent ruling by Virginia Judge Norman Moon upholding the constitutionality of the law. However, Florida appears to be leading the charge in the fight against the law. Back in October, U.S. District Court Judge Roger Vinson gave the go-ahead to a 20-state lawsuit, filed by Florida Attorney General Bill McCollum. While the Florida court dismissed four counts, the court denied motions to dismiss counts regarding the individual mandate and Medicaid expansion – two key issues bundled within the reform package.

“As the nonpartisan CBO concluded 16 years ago (when the individual mandate was considered, but not pursued during the 1994 national health care reform efforts): “A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States … at this stage of the case, the plaintiffs have most definitely stated a plausible claim with respect to this cause of action,” Vinson explained in his ruling.

And that’s not all. Rep. Dean Cannon spoke out against reform on his first day as Florida’s new House speaker, asking, “Should it really be the role of government to require people to purchase a health insurance product they don’t want, raise taxes to give that same product to others who can’t afford it, and commandeer our state government and its resources to carry it out? Or, should we work to limit government and empower the private sector?”

Among the movements roiling in the state capital, GOP legislators recently re-filed an altered version of a constitutional amendment first drafted in the spring, which originally instructed that Florida businesses and residents couldn’t be forced to buy insurance. Though a Tallahassee judge dismissed the movement from the November ballot on the grounds that its language was misleading, lawmakers hope to place the updated version in front of voters in 2012. State put in place to determine whether health care reform provisions might harm insurance agents. And legislative leaders are looking to block the spending and rules that drive the very core provisions of the bill, including a refusal on the part of state regulators to impose the medical loss ratio requirements that may spell refunds for consumers – but which health carriers claim would put a dent in their profits. The lawmakers have the backing of Gov.-elect Rick Scott, who has stated that he simply won’t allow the state to help health reform come to fruition.

Florida has 3.8 million uninsured residents, making it one of the top states that reform would affect. Yet the state appears to be proving the law’s central philosophy to be incorrect: that the states would drive most of the systematic changes contained within the package. In the time remaining before 2014, when the most dramatic provisions are scheduled to kick in, Florida could prove to be an even more formidable opponent than ever before. Already, about half a dozen up-and-coming Republicans are stating their tentative plans to take on Democratic Sen. Bill Nelson in 2012. Among those leading the race? Mike Haridopolos, the new state Senate president, who stated that his physician wife cried when the House passed health care reform in March.