A second court has ruled that the individual mandate to maintain health insurance coverage under the Patient Protection and Affordable Care Act (PPACA) is unconstitutional. State of Florida v. U.S. Dept. of Health and Human Services (Case No.: 3:10-cv-91RV/EMT). With this decision by the U.S. District Court for the Northern District of Florida (Pensacola Division) on January 31, 2011, there are now two decisions upholding the individual mandate as constitutional and two rulings that it is unconstitutional because it exceeds Congressional authority under the Commerce Clause.