What significant aspect of the ACA was ruled unconstitutional by the Supreme Court in 2012?

The Supreme Court's ruling in 2012 addressed the individual mandate within the Affordable Care Act (ACA), which required that most Americans obtain health insurance or pay a penalty. The Court ruled that while the mandate itself was constitutional under Congress's taxing authority, the penalties associated with failing to comply could not be enforced. This means that while the individual mandate remained intact, the penalties that were supposed to incentivize compliance were deemed unconstitutional.

This ruling significantly impacted the ACA's framework, as it effectively removed a major enforcement mechanism designed to encourage everyone to participate in the health insurance market, which was critical for maintaining a balanced risk pool in the ACA exchanges. The decision did not undermine other components of the ACA, such as Medicaid expansion or the establishment of health insurance exchanges, which continued to function as intended under the law.