National Federation of Independent Business et al. v. Kathleen Sebelius, Secretary of Health and Human Services, et al.

The case of National Federation of Independent Business et al. v. Kathleen Sebelius, Secretary of Health and Human Services, et al., often referred to as the Affordable Care Act cases, involved a challenge to the constitutionality of the Patient Protection and Affordable Care Act (PPACA), commonly known as the Affordable Care Act (ACA). The National Federation of Independent Business (NFIB), representing small businesses, argued that the individual mandate, requiring most Americans to obtain health insurance or pay a penalty, was an unconstitutional financial burden.12

In a significant decision, the U.S. Supreme Court, in a 5-4 majority opinion written by Chief Justice John Roberts, Jr., upheld the individual mandate, but reinterpreted it as a tax, falling within Congress's constitutional power to tax and spend. The Court also addressed the expansion of Medicaid, ruling that while the expansion was coercive, states could not be penalized by the withholding of all federal Medicaid funds.31