Republicans in the US Senate have failed to win enough votes to repeal President Barack Obama's healthcare reform bill, which was passed last March.
The Republicans have 47 seats in the chamber, which is controlled by the Democrats.
The House of Representatives, led by the Republicans, voted last month to repeal the bill.
The Supreme Court is now likely to have the final say on the healthcare law.
On Monday, a judge in Florida ruled against the legislation on the grounds that a requirement that Americans purchase health insurance or face penalties violates an individual's rights.
Because mandatory individual insurance is central to the bill, Judge Roger Vinson struck down the entire act.
The BBC reports the Department of Justice said it would appeal against the ruling and the case is likely to end up in the Supreme Court.
Two other federal judges have upheld the law, but a judge in Virginia also struck down the individual mandate.