The US Supreme Court rejected Virginia's request Monday to immediately rule on whether President Barack Obama's sweeping health care reform is constitutional.
The decision left the lower courts to hash out the issue before the highest court in the land would make a final ruling, likely further prolonging the already bitter legal fight over the controversial law overhauling America's troubled health care system.
It also marked the second time the Supreme Court denied a request from critics of the reform for an expedited review, without the issue being examined thoroughly in appeals courts first.
But the decision was not surprising. While US law allows for cases to be examined directly by the Supreme Court without first going to an appeals court, the process is exceedingly rare.
Virginia Attorney General Ken Cuccinelli, a Republican, had requested that the top US court issue to hear arguments in the case before the Fourth Circuit US Court of Appeals in his state's capital of Richmond does so.
"Regardless of whether you believe the law is constitutional or not, we should all agree that a prompt resolution of this issue is in everyone's best interest," Cuccinelli wrote in February upon making his request.
The law, one of Obama's key domestic achievements, has been hotly debated and challenged across the United States since Congress passed it last year, and legal experts believe a challenge to the law -- which extends coverage to some 32 million uninsured Americans -- will make its way to the Supreme Court.
Two Republican-appointed federal judges -- in Virginia and Florida -- have already declared the law unconstitutional, saying a key provision of the law known as the "individual mandate" exceeds Congress's regulatory powers by requiring Americans to either purchase health insurance by 2014 or pay a fine.
But, in another sign of how the rulings have been largely split along party lines, three Democratic appointees have upheld the law -- in Michigan, Virginia and the US capital Washington.
Governors and attorneys general from 26 US states have also found the provision unconstitutional in a separate lawsuit.
Related hearings are scheduled in several appeals courts.
The Richmond court is due to examine a decision backing the reform and one against it during a hearing on May 10.
Explore further: Physician/Pharmacist model can improve mean BP