By KEVIN MCGILL

NEW ORLEANS (AP) — Democrats used an unconstitutional amendment process to get President Barack Obama’s signature health care overhaul through Congress, opponents of the law told a federal appeals court Tuesday in one of the latest legal challenges to the act.

Health care law opponents told a three-judge panel of the 5th U.S. Circuit Court of Appeals that the bill, which includes tax penalties for individuals who fail to purchase insurance and employers who fail to provide it, violates the Constitution’s requirement that tax measures must start in the House. The lawsuit contends that the law, in effect, originated in the Senate, because senators took an unrelated tax bill passed by the House, gutted it, and substituted the health care language before sending it back to the House for final passage.

That argument was rejected earlier this year by U.S. District Judge Nancy Atlas of Texas. Atlas ruled that the bill met constitutional requirements because raising revenue was not its overarching purpose and the law was therefore not subject to the origination clause. She also noted that the original House bill was indeed a revenue measure and said the Senate had broad authority to amend the bill once it left the House.

Gregory Katsas, arguing for congressional opponents of the Affordable Care Act, said Atlas was interpreting that amendment power too broadly. Her ruling, he told the appeals judges, “would make vast swaths of taxes totally exempt from the origination clause.”

Judge E. Grady Jolly, one of the three judges hearing the appeal, questioned whether the origination clause has any real meaning if the Senate is allowed to completely gut the House measure and substitute a new bill.

But attorneys supporting the law cited Supreme Court and 5th Circuit precedents that they said support Atlas’ ruling.

Attorney Alisa Klein, arguing for the Justice Department, said no House members argued that the origination clause was being violated when the law was making its way through Congress in 2009 and 2010.

And Attorney Elizabeth Wydra, arguing for congressional supporters of the measure, said House members still zealously guard their prerogative to start tax legislation. “The origination clause continues to be something that is alive and well in the House,” Wydra said.

The panel gave no indication when it would rule. Sitting with Jolly, who was nominated to the court by President Ronald Reagan, were Judges Carolyn Dineen King, nominated by President Jimmy Carter, and Gregg Costa, an Obama nominee approved by the Senate earlier this year.

Although the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act in 2012, legal challenges continue.

The high court last month agreed to review a federal appeals court ruling that upheld IRS regulations allowing health-insurance tax credits under the Affordable Care Act for consumers in all 50 states. Opponents argue that most of the subsidies are illegal.

The origination clause argument has already been rejected by the District of Columbia appeals court in a 3-0 ruling in July. A different ruling by the 5th Circuit could keep the issue alive and make it ripe for Supreme Court arguments.