Five more states have joined the lawsuit challenging the constitutionality of the federal health reform law.
Indiana, North Dakota, Mississippi, Nevada, and Arizona announced this week that they will join 13 other states that filed suit just minutes after President Obama signed the law on March 23.
Florida Attorney General Bill McCollum, a Republican who is running for governor, filed the initial suit last month and said Wednesday he welcomes the additional support "as we continue fighting to protect the constitutional rights of American citizens and the sovereignty of our states."
Among its myriad complaints, the lawsuit, filed in U.S. District Court in Pensacola, FL, alleges that the law violates the constitution by mandating all citizens and legal residents have healthcare coverage or pay a penalty.
Nevada joined the suit without the support of Democratic Attorney General Catherine Cortez Masto.
When Masto refused to join the suit, the state's Republican Gov. Jim Gibbons signed an executive order that circumvented the Attorney General's office and assigned outside legal counsel to represent the state in the suit. Masto office is considering filing suit to block the order, her spokeswoman said.
North Dakota Republican Attorney General Wayne Stenehjem, a Republican, said the lawsuit "will test the most objectionable of those flaws, the so-called individual mandate."
"The individual mandate in the healthcare law is unprecedented—a direct federal requirement for an individual to purchase insurance from a private company," said Stenehjem.
He added that by 2016, an adult who does not have health insurance would be penalized $695 per year, and a family up to $2,085, or 2.5% of income, whichever is greater.
"Never before has Congress, under the commerce clause, required Americans to purchase any good or service, and it certainly has never claimed the commerce clause regulates citizens who decline to participate in the marketplace by refusing to purchase goods or services."
Joining McCollum in the initial suit filed last month were attorneys general from South Carolina, Nebraska, Texas, Utah, Alabama, Colorado, Michigan, Pennsylvania, Washington, Idaho, and South Dakota, all Republicans; and Louisiana's Buddy Caldwell, a Democrat.
A hearing is set for April 14 in Pensacola.
Critics of the suit have dismissed it as groundless, and a political stunt designed to take advantage of public angst over the issue during an election year.
Several attorneys general who joined the suit are also running for governor, including McCollum, Terry Goddard, the Democratic attorney general of Nevada, and Greg Zoeller, the Republican attorney general from Indiana.
Republican lawmakers in Georgia additionally have threatened to impeach Democratic Attorney General Thurbert Baker, because he refused Republican Gov. Sonny Purdue's request to join the suit.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.