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Page Number: 53

28 

CALIFORNIA v. TEXAS 

ALITO, J., dissenting 

and community rating requirements would not work with-
out the” individual mandate).

Thus, the guaranteed-issue and community-rating provi-
sions were crucial to the success of the ACA scheme, and a 
tax or penalty for noncompliance with the individual man-
date  was  essential  to  the  ACA’s  distribution  of  risks  and 
burdens.  The ACA contains an express finding on exactly 
that point: 

“The  requirement  [i.e.,  the  individual  mandate]  is  es-
sential to creating effective health insurance markets
in which improved health insurance products that are
guaranteed  issue  and  do  not  exclude  coverage  of  pre-
42  U. S. C. 
existing  conditions  can  be  sold.” 
§18091(2)(I) (emphasis added). 

See  also  NFIB,  567  U. S.,  at  694–696  (joint  dissent)  (de-
scribing other statutory provisions declaring that the indi-
vidual mandate works “together” with the rest of the ACA).
In  NFIB,  the  Government  agreed  that  the  individual 
mandate  was  inextricably  related  to  those  crucial  provi-
sions.  See  id.,  at  650  (citing  Brief  for  Petitioners,  O.  T. 
2011,  No.  11–398,  p. 24).    And  so  did  Justice  Ginsburg’s
opinion.  See 567 U. S., at 597 (“[T]hese two provisions [i.e., 
the  guaranteed-issue  and  community-rating  provisions], 
Congress comprehended, could not work effectively unless 
individuals were given a powerful incentive to obtain insur-
ance”); see also ibid. (quoting congressional testimony that 
the  insurance  market  would  be  “ ‘drive[n]  . . .  into  extinc-
tion’ ” without “ ‘a mandate on individual[s] to be insured’ ”).
Recognizing  this  relationship,  the  joint  dissent,  after
finding that the individual mandate and Medicaid expan-
sion provision were unconstitutional, concluded that other 
provisions of the ACA could not be enforced.  We analyzed
this question under what we described as the Court’s “ ‘well 
established’ ” two-part test.  Id., at 692 (joint dissent) (quot-
ing Alaska Airlines, 480 U. S., at 684).