Document ID: ./input/supremecourt_opinions/opinions/20pdf/19-840_6jfm.pdf
Page Number: 54

Cite as:  593 U. S. ____ (2021) 

29 

ALITO, J., dissenting 

Under  this  test,  the  first  question  was  whether  the  re-
mainder of the ACA would “operate in the manner Congress
intended” without the unconstitutional provisions.  NFIB, 
567 U. S., at 692.  And to satisfy this requirement, we ex-
plained,  it  was  not  enough  that  the  remaining  provisions
could operate by themselves “in some coherent way.”  Ibid. 
The question, instead, was whether those provisions would 
operate as Congress wrote them.  Ibid.  If this requirement
was met, the second part of the test asked whether “Con-
gress  would  have  enacted  [the  other  provisions]  standing 
alone  and  without  the  unconstitutional  portion.”  Id.,  at 
693; see id., at 692–694. 

Applying this test, we concluded that, without the uncon-
stitutional provisions, neither the other ACA provisions we
labeled “major” nor many of those we described as “minor” 
could operate as Congress intended.  Id., at 697–705.  And 
we  opined  that  Congress  would  not  have  enacted  the  re-
maining minor provisions by themselves.  Id., at 704–705. 
We noted that they had been adopted as part of a complex 
package  deal  and  that  “[t]here  [was]  no  reason  to  believe 
that  Congress  would  have  enacted  them  independently.” 
Id., at 705. 

Nothing that has happened since that decision calls for a
different conclusion now.  It is certainly true that the repeal
of the tax or penalty has not caused the collapse of the en-
tire  ACA  apparatus,  but  the  critical  question  under  the
framework applied in the NFIB dissent is not whether the 
ACA  could  operate  in  some  way  without  the  individual 
mandate but whether it could operate in anything like the
manner Congress designed.  The answer to that question is 
clear.  When  the  tax  or  penalty  was  collected,  costs  were 
shifted from individuals previously denied coverage due to 
their  medical  conditions  and  placed  on  others  who  pur-
chased  insurance  only  because  the  failure  to  do  so  was 
taxed or penalized.  The repeal of the tax or penalty has not 
made  the  costs  of  the  guaranteed-issue  and  community-