WASHINGTON (AP) — A federal judge on Tuesday threw out a lawsuit claiming that President Barack Obama’s requirement that all Americans have health insurance violates the religious freedom of those who rely on God to protect them.

U.S. District Judge Gladys Kessler in Washington dismissed a lawsuit filed by the American Center for Law and Justice, a Christian legal group founded by evangelist Pat Robertson, on behalf of five Americans who can afford health insurance but have chosen for years not to buy it.

The case was one of several lawsuits filed against Obama’s requirement that Americans either buy health insurance or pay a penalty, beginning in 2014.

Kessler is the third Democratic-appointed judge to dismiss a challenge, while two Republican-appointed judges have ruled part or all of the law unconstitutional. Kessler wrote that the Supreme Court will need to settle the constitutional issues.

Three of the plaintiffs — Margaret Peggy Lee Mead of Hillsborough, N.C., Charles Edward Lee of San Antonio and Susan Seven-Sky of West Harrison, N.Y. — are Christians who said they want to refuse all medical services for the rest of their lives because they believe God will heal their afflictions. They say being forced to buy insurance would conflict with their faith because they believe doing so would indicate they need “a backup plan and (are) not really sure whether God will, in fact, provide,” the lawsuit said.

The two other plaintiffs — Kenneth Ruffo of San Antonio and Gina Rodriguez of Plano, Texas — have a holistic approach to medical care and prefer to pay for their health services out of pocket, in part because insurance often doesn’t cover their chosen methods of healing.

The lawsuit argued that Congress does not have the power under the Constitution to require health care purchases and that the mandate violates the Religious Freedom Restoration Act of 1993.

Kessler rejected both arguments and ruled that Congress has the right to regulate health care spending under the Commerce Clause and that the individual mandate must be viewed not as a stand-alone reform but as an essential part of the law Obama signed 11 months ago aimed at reducing overall costs.     She also said that anyone who objects to having health care for religious reasons can choose to pay the penalty instead — as the lawsuit said all five plaintiffs plan to do.

Kessler also expressed doubts that they can really determine whether they will never require health care. “Individuals like plaintiffs who allege now that they will refuse medical services in the future may well find their way into the health care market when they face the reality of illness or injury,” she wrote.

Judges George Steeh of Michigan and Norman Moon of Virginia — like Kessler, they were nominated to the federal bench by President Bill Clinton — dismissed suits against the individual mandate last fall. George W. Bush-appointed Henry Hudson in Virginia ruled the insurance purchase requirement unconstitutional in December, while Ronald Reagan appointee Roger Vinson in Florida ruled the entire health care reform act unconstitutional last month.

The Justice Department, which has been defending the law in court, noted that the law has now been upheld more times than not.

“We welcome this ruling, which marks the third time a court has reviewed the Affordable Care Act on the merits and upheld it as constitutional,” said spokeswoman Tracy Schmaler. “This court found — as two others have previously — that the minimum coverage provision of the statute was a reasonable measure for Congress to take in reforming our health care system.”

• Nedra Pickler