the unconstitutionality of the aca without the individual mandate in december 2019. the case was raised to the supreme court to be heard as california v. texas during the court's 2020–21 term; in a 7–2 decision issued on june 17, 2021, the court ruled that texas and other states that initially challenged the individual mandate did not have standing, as they had not shown past or future injury related to the provision. the supreme court otherwise did not rule on the constitutionality of the individual mandate in this case. constitutional challenges the aca mandate was challenged in federal courts by republican state attorneys general. on june 28, 2012, the u.s. supreme court upheld the provision as constitutional. chief justice john roberts delivered the majority opinion in national federation of independent business v. sebelius, which upheld the patient protection and affordable care act by a 5–4 vote. the court ruled that although the "individual mandate" component of the act was not constitutional under the commerce clause, it was reasonably construed as a tax and was therefore valid under the congressional authority to "lay and collect taxes." in a september 2010 working paper, a forthcoming article in the nyu journal of law and liberty, and a lecture given at nyu, randy barnett of georgetown university law center argues that the mandate is unconstitutional under the doctrine of the commerce and necessary and proper clauses, and that enforcing it is equivalent to "commandeering the people." penalizing inaction, he argues, is only defensible when a fundamental duty of a person has been established. he also asserted that congress fails to enforce the mandate under its taxing power because the penalty is not revenue-generating according to the act itself. the u.s. supreme court decision upholding the individual mandate was rendered in june 2012, in the case of national federation of independent business v. sebelius. criticism of individual mandate insurance lobbyists (ahip) in the united states advocate that the mandate is necessary to support guaranteed issue and community rating, which limit underwriting by insurers; insurers propose that the mandate is intended to prevent adverse selection by ensuring healthy individuals purchase insurance and thus broaden the risk pool. the mandate has been considered at the heart of health care reform proposals in the united states and "absolutely necessary" pre-condition to universal health care, since any non-compulsory reform would fail to expand coverage. a 2008 ahip/kaiser forum cited dutch and swiss mandates (see above); ahip's published report does not mention penalties but says switzerland "enforces the rules in many ways..." in october 2009, kaiser health news reported that "the insurance industry is clearly worried about the mandate being defanged." some studies of empirical evidence suggest that the threat of adverse selection is exaggerated, and that risk aversion and propitious selection may balance it. for example, several us states have guaranteed issue and limits on rating, but only massachusetts has an individual mandate; similarly, although japan has a nominal mandate, around 10% of individuals do not comply, and there is no penalty (they simply remain uninsured - see above). without mandates, for-profit insurers have necessarily relied on risk aversion to charge premiums over expected risks, but have been constrained by what customers are willing to pay; mandates eliminate that constraint, allowing insurers to charge more. governments that impose a mandate must subsidize those who cannot afford it, thus shifting the cost onto taxpayers. university of chicago economist casey b. mulligan argues that, despite adverse selection, an individual mandate is unnecessary and reducing efficiency as long as insurance is subsidized enough. “consumers who turn down the government aid by failing, say, to buy a subsidized plan are owed gratitude by us federal taxpayers. the aca did the opposite with its ‘individual mandate’....” a cost-benefit analysis confirming mulligan’s argument appeared in the 2019 economic report of the president, which also concludes that adverse selection is not sufficient economic justification for prohibiting unsubsidized plans that exclude “essential benefits” such as coverage for maternity or mental health. the insurance mandate faced opposition across the political spectrum, from left-leaning groups such as the green party and other advocates of single-payer healthcare to right-leaning groups such as the heritage foundation, freedomworks, and the cato institute as well as some members of the u.s. senate and house of representatives. opponents such as michael cannon, director of health policy studies at the cato institute, make a philosophical argument that people should have the right to live without government social interference as a matter of individual liberty. he has stated that federal, state, and local governments are not willing or able to raise the necessary funds to effectively subsidize people who cannot currently afford insurance. he has also stated that the costs of increasing coverage are far higher than other reforms, such as reducing the number of errors and accidents in treatment, which would accomplish as much or more benefit to society. public opinion polls from 2009 through 2012 continued to find that most americans rejected penalizing people for not buying health insurance. employer mandates in the united states, the patient protection and affordable care act (ppaca) includes both employer and individual mandates that take effect in 2014. the ppaca's employer mandate requires that all businesses with 50 or more full-time employees provide minimum affordable health insurance to at least 95% of their full-time employees and dependents up to age 26, or pay a fee by 2016. in the two largest eu countries, france and germany, statutory health insurance (shi) mandates employers and employees pay into statutory sickness funds. in france, private health insurance (phi) is voluntary and used to increase the reimbursement rate from the statutory sickness system. the same applies in germany where it is also possible to opt out of shi if you are a very high earner and into a phi but if a person has reached the age of 55 and is in the phi sector he or she must remain covered by phi and cannot opt back into shi. persons who are unemployed can usually continue their payments through social insurance and the very poor receive support from the government to be insured. most workers are insured through compulsory membership of "sickness funds" that are non-profit entities established originally by trades unions and now given statutory status. in germany and france, as is the case with most european health care finance, the personal contribution to health care financing varies according to a person's income level and not according to their health status. only 0.2% of germans are uninsured, mainly self-employed, rich and poor, and persons who have failed to pay contributions to the statutory insurance or premiums to the private health insurance. between 1990 and 2000 the share of french shi income coming directly from employees via salaries fell from around 30% to just 3% and employer direct contributions also fell. the difference was made up by a rise in income from government taxation, thus widening the mandatory contribution base to the health insurance system.