Document ID: ./input/supremecourt_opinions/opinions/20pdf/19-840_6jfm.pdf
Page Number: 3.0

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

3 

Syllabus 

547 U. S. 332, 342.  They allege two forms of injury: one indirect, one 
direct. 

(1) The  state  plaintiffs  allege  indirect  injury  in  the  form  of  in-
creased costs to run state-operated medical insurance programs.  They
say the minimum essential coverage provision has caused more state 
residents  to  enroll  in  the  programs.    The  States,  like  the  individual 
plaintiffs,  have  failed  to  show  how  that  alleged  harm  is  traceable  to 
the Government’s actual or possible action in enforcing §5000A(a), so
they lack Article III standing as a matter of law.  But the States have 
also not shown that the challenged minimum essential coverage provi-
sion, without any prospect of penalty, will injure them by leading more
individuals to enroll in these programs.  Where a standing theory rests
on speculation about the decision of an independent third party (here 
an  individual’s  decision  to  enroll  in  a  program  like  Medicaid),  the
plaintiff must show at the least “that third parties will likely react in 
predictable  ways.”  Department  of  Commerce  v. New York,  588  U. S. 
___,  ___.    Neither  logic  nor  evidence  suggests  that  an  unenforceable
mandate will cause state residents to enroll in valuable benefits pro-
grams that they would otherwise forgo.  It would require far stronger 
evidence than the States have offered here to support their counterin-
tuitive theory of standing, which rests on a “highly attenuated chain 
of possibilities.”  Clapper v. Amnesty Int’l USA, 568 U. S. 398, 410–411. 
Pp. 11–14. 

(2) The  state  plaintiffs  also  claim  a  direct  injury  resulting  from  a 
variety of increased administrative and related expenses allegedly re-
quired  by  §5000A(a)’s  minimum  essential  coverage  provision.    But 
other provisions of the Act, not the minimum essential coverage provi-
sion, impose these requirements.  These provisions are enforced with-
out reference to §5000A(a).  See 26 U. S. C. §§6055, 6056.  A conclusion 
that the minimum essential coverage requirement is unconstitutional
would not show that enforcement of these other provisions violates the
Constitution.  The other asserted pocketbook injuries related to the Act 
are  similarly  the  result  of  enforcement  of  provisions  of  the  Act  that 
operate independently of §5000A(a).  No one claims these other provi-
sions violate the Constitution.  The Government’s conduct in question
is therefore not “fairly traceable” to enforcement of the “allegedly un-
lawful” provision of which the plaintiffs complain—§5000A(a).  Allen, 
468 U. S., at 751.  Pp. 14–16. 

945 F. 3d. 355, reversed and remanded. 

BREYER, J., delivered the opinion of the Court, in which ROBERTS, C. J., 
and THOMAS, SOTOMAYOR, KAGAN, KAVANAUGH, and BARRETT, JJ., joined. 
THOMAS, J., filed a concurring opinion.  ALITO, J., filed a dissenting opin-
ion, in which GORSUCH, J., joined.