Instead, the Government asks us to read the mandate not as ordering individuals to buy insurance, but rather as imposing a tax on those who do not buy that product. Certain individuals sought an exemption from that regulation on the ground that they engaged in only intrastate possession and consumption. Petitions Nos. 26  Federal taxation of a State’s citizens, according to the joint dissenters, may diminish a State’s ability to raise new revenue. That system of incentives collapses if the federal subsidies are invalidated. certiorari to the united states court of appeals for the eleventh circuit. The Framers understood that the “general Interests of the Union” would change over time, in ways they could not anticipate. 20  The Deficit Reduction Act of 2005 authorized States to provide “benchmark coverage” or “benchmark equivalent coverage” to certain Medicaid populations. See §300gg. 12  See Statistical Abstract of the United States: 2012, p. 268 (Table 431, Federal Grants-in-Aid to State and Local Governments: 1990 to 2011). . 79 (Mar. of State Budget Officers, Fiscal Year 2010 State Expenditure Report, p. 11, Table 5 (2011); 42 U. S. C. §1396d(b). The States contend that Congress enacted the rest of the Act with such full participation in mind; they point out that Congress made Medicaid a means for satisfying the mandate, 26 U. S. C. §5000A(f)(1)(A)(ii), and enacted no other plan for providing coverage to many low-income individuals. See also Lipke v. Lederer, 259 U. S. 557 (1922) (same). 1. Today’s holding does not affect the continued ap-plication of §1396c to the existing Medicaid program. The phrase “independently authorized” suggests the existence of a creature never hitherto seen in the United States Reports: A penalty for constitutional purposes that is also a tax for constitutional purposes. Absent from the nationalized model, of course, is the state-level policy discretion and experimentation that is Medicaid’s hallmark; undoubtedly the interests of federalism are better served when States retain a meaning- ful role in the implementation of a program of such importance. 12–14. Someone with an annual income of $100,000 a year would likely owe about $200. . §38.2–3430.1:1 (Lexis Supp. Everyone will, at some point, consume health-care products and services. Whether the mandate can be upheld under the Commerce Clause is a question about the scope of federal authority. It amounts instead to a vast judicial overreaching. Amicus also suggests that the penalty should be treated as a tax because it is an assessable penalty, and the Code’s assessment provision authorizes the Secretary of the Treasury to assess “all taxes (in- cluding interest, additional amounts, additions to the tax, and as- sessable penalties) imposed by this title.” §6201(a) (2006 ed., Supp. (emphasis added). The Government claims that Congress has power under the Commerce and Necessary and Proper Clauses to enact this solution. And Congress’s choice of language—stating that individuals “shall” obtain insurance or pay a “penalty”—does not require reading §5000A as punishing unlawful conduct. . 26 U. S. C. §5000A. C. Dubay, Tax Foundation, Federal Tax Burdens and Expenditures by State: Which States Gain Most from Federal Fiscal Operations? To manage the risks associated with medical care— its high cost, its unpredictability, and its inevitability—most people in the United States obtain health insurance. See, e.g., South Dakota v. Dole, 483 U. S. 203, 205–206 (1987) (conditioning federal highway funds on States raising their drinking age to 21). . 248, p. 71, Table 25 (Dec. 2010). See, e.g., Brief for Economists as Amici Curiae in No 11–400, p. 11. 2 (Mar. There is a second reason why, if community rating is invalidated by the Mandate and Medicaid Expansion’s invalidity, exchanges cannot be implemented in a manner consistent with the Act’s design. 18–19 (Mar. Post, at 35. . The Court found that the condition was “directly related to one of the main purposes for which highway funds are expended—safe interstate travel.” 483 U. S., at 208. E.g., United States v. Comstock, 560 U. S. ___. With no exchanges, there are no purchases on the exchanges; and with no purchases on the exchanges, there is nothing to trigger the employer-responsibility assessment. The Federal Government, the States, and private parties ought to know at once whether the entire legislation fails. The dissent itself treats the question here as one of statutory interpretation, and indeed also relies on a statutory interpretation case from the bankruptcy context. This included the requirement for Americans to have health insurance by 2014. See Schweiker v. Gray Panthers, 453 U. S. 34, 38 (1981). 14, would have made superfluous the later provision for authority “[t]o raise and support Armies,” id., §8, cl. 1059 (excise tax). It would be particularly destructive of sound government to apply such a rule with regard to a multifaceted piece of legislation like the ACA. 3. If anything, the Court’s analysis suggested the latter. On this logic, any federal spending program, sufficiently large and well-funded, would be unconstitutional. (noting that the Court would have “to pile inference upon inference” to conclude that gun possession has a substantial effect on commerce). Under pre-ACA Medicaid, the Federal Government pays up to 83% of the costs of coverage for current enrollees, §1396d(b) (2006 ed. In the seven States that tried guaranteed-issue and community-rating requirements without a minimum coverage provision, that is precisely what insurance companies did. §1396d(y)(1). And each successive Congress is empowered to appropriate funds as it sees fit. It is certain that many of them would not have, and it is not a proper function of this Court to guess which. Kaiser Comm’n on Medicaid and the Uninsured, Performing Under Pressure 11, and fig. The coercion inquiry, therefore, appears to involve polit- ical judgments that defy judicial calculation. The dissent claims that we “fai[l] to explain why the individual mandate threatens our constitutional order.” Ante, at 35. 1. And even in States with less than average federal Medicaid funding, that funding is at least twice the size of federal education funding as a percentage of state expenditures. . This rigid reading of the Clause makes scant sense and is stunningly retrogressive. A mandate to purchase a particu- lar product would be unconstitutional if, for example, the edict impermissibly abridged the freedom of speech, interfered with the free exercise of religion, or infringed on a liberty interest protected by the Due Process Clause. ORDER OF NOVEMBER 18, 2011 H. BARTOW FARR, III, ESQ. Thus, the decision whether to comply with the federal condition “remain[ed] the prerogative of the States not merely in theory but in fact,” and so the program at issue did not exceed Congress’ power. . certiorari to the united states court of appeals for the eleventh circuit. That decision, when considered in the aggregate along with sim-ilar decisions of others, would have had a substantial ef-fect on the interstate market for wheat. Consistent with the Framers’ intent, we have repeatedly emphasized that Congress’ authority under the Commerce Clause is dependent upon “practical” considerations, including “actual experience.” Jones & Laughlin Steel Corp., 301 U. S., at 41–42; see Wickard v. Filburn, 317 U. S. 111, 122 (1942); United States v. Lopez, 514 U. S. 549, 573 (1995) (Kennedy, J., concurring) (emphasizing “the Court’s definitive commitment to the practical conception of the commerce power”). The question posed by the 2010 Medicaid expansion, then, is essentially this: To cover a notably larger population, must Congress take the repeal/reenact route, or may it achieve the same result by amending existing law? Instead, acceptance of the offer will impose very substantial costs on participating States. Indeed, the Constitution did not initially include a Bill of Rights at least partly because the Framers felt the enu-meration of powers sufficed to restrain the Government. of Health and Human Services, Centers for Medicare and Medicaid Services, Historic National Health  Expenditure Data, National Health Expenditures: Se- lected Calendar Years 1960–2010 (Table 1). As for the Medicaid expansion, that portion of the Affordable Care Act violates the Constitution by threatening existing Medicaid funding. We held that “[i]n such circumstances, if in no others, inducement or persuasion does not go beyond the bounds of power.” Ibid. The majority therefore determined that the plaintiffs could not challenge the individual mandate until after they paid the penalty.1. The Government’s first argument is that the individual mandate is a valid exercise of Congress’s power under the Commerce Clause and the Necessary and Proper Clause. It is up to Con-gress whether to apply the Anti-Injunction Act to any particular statute, so it makes sense to be guided by Congress’s choice of label on that question. The most straightforward reading of the mandate is that it commands individuals to purchase insurance. The Affordable Care Act is constitutional in part and unconstitutional in part. 543, p. 40 (“novel assertion of federal power”); Brief for Appellee in Wickard v. Filburn, O. T. 1941, No. One preliminary point should be noted before applying severability principles to the Act. The Court does so today. The syllabus constitutes no part of the opinion of the Court but has been prepared by the Reporter of Decisions for the convenience of the reader. It determines that Congress has used an existing one. Arguing to the contrary, The Chief Justice notes that “the Constitution gives Congress the power to ‘coin Money,’ in addition to the power to ‘regulate the Value thereof,’ ” and similarly “gives Congress the power to ‘raise and support Armies’ and to ‘provide and maintain a Navy,’ in addition to the power to ‘make Rules for the Government and Regulation of the land and naval Forces.’ ” Ante, at 18–19 (citing Art. If that analysis is correct, the regulations and taxes will mean higher costs for insurance companies. 88, 42 U. S. C. §1396u–7 (2006 ed. The Federal Government “is acknowledged by all to be one of enumerated powers.” Ibid. and Supp. §1396a(a)(10)(A)(i)(VIII). The values that should have determined our course today are caution, minimalism, and the understanding that the Federal Government is one of limited powers. We unanimously rejected California’s argument. Nor does The Chief Justice pause to explain why the power to direct either the purchase of health insurance or, alternatively, the payment of a penalty collectible as a tax is more far-reaching than other implied powers this Court has found meet under the Necessary and Proper Clause. J. Pp. The shared responsibility payment is thus not a direct tax that must be apportioned among the several States. See Nat. of Ed., 470 U. S. 656, 669 (1985). Cf. Three considerations allay this concern. . See Lopez, 514 U. S., at 564 (“[I]f we were to accept the Government’s arguments, we are hard pressed to posit any activity by an in- dividual that Congress is without power to regulate”). 11–398 (Minimum Coverage Provision) 24 (hereinafter Petitioners’ Minimum Coverage Brief). To capture individuals who unexpect- edly will obtain medical care in the very near future, then, Congress needed to include individuals who will not go to a doctor anytime soon.