Judge Robert Vinson, a Senior United States District Judge for the Northern District of Florida, has determined that The Patient Protection and Affordable Care Act is unconstitutional. Judge Vinson begins his opinion by reiterating the importance of the federalist system. In framing the question before the Court, Vinson emphasizes that this question is not about the health care system, but about the federalist system and the very important issues regarding the Constitutional role of the Federal government. Vinson quotes Federalist 51 and the 10th Amendment in articulating the Framers intent of a limited federal government. Vinson states: Rather than being the mere historic relic of a bygone era, the principle behind a central government with limited power has never been more relevant than in this day, when accretion, if not actual accession, of power to the federal government seems not only unavoidable, but even expedient. There were two causes of action remaining before Judge Vinson: (1) the individual mandate violates the Commerce Clause (Count I) and (2) [t]he expansion of Medicaid violates the Spending Clause and principles of federalism protected under the 9th and 10th Amendments (Count IV).