NFIB Sebelius Dissent



strictions articulated in our cases””).  For one thing, any
such conditions must be unambiguous so that a State at
least knows what it is getting into.  See Pennhurst, supra,  
at 17.  Conditions must also be related “”to the federal
interest in particular national projects or programs,””
Massachusetts  v. United States, 435 U. S. 444, 461 (1978),
and the conditional grant of federal funds may not ““induce
the States to engage in activities that would themselves be
unconstitutional,””  Dole, supra, at 210; see Lawrence County  
v. Lead-Deadwood School Dist. No. 40–-1, 469 U. S.
256, 269–-270 (1985).  Finally, while Congress may seek to
induce States to accept conditional grants, Congress may
not cross the “”point at which pressure turns into compul-
sion, and ceases to be inducement.”” Steward Machine, 301
U. S., at 590. Accord, College Savings Bank, supra, at 687;
Metropolitan Washington Airports Authority v. Citizens for  
Abatement of Aircraft Noise, Inc., 501 U. S. 252, 285 (1991)
(White, J., dissenting); Dole, supra, at 211.

 When federal legislation gives the States a real choice
whether to accept or decline a federal aid package, the
federal-state relationship is in the nature of a contractual
relationship.  See Barnes v. Gorman, 536 U. S. 181, 186
(2002); Pennhurst, 451 U. S., at 17.  And just as a contract
is voidable if coerced, “”[t]he legitimacy of Congress’’ power
to legislate under the spending power . . . rests on whether
the State voluntarily and knowingly accepts the terms
of the ‘’contract.'””  Ibid. (emphasis added). If a federal
spending program coerces participation the States have
not “”exercise[d] their choice”-”—let alone made an ““informed
choice.”” Id., at 17, 25.

 Coercing States to accept conditions risks the destruc-
tion of the “”unique role of the States in our system.””
Davis, supra, at 685 (KENNEDY, J., dissenting). “”[T]he
Constitution has never been understood to confer upon
Congress the ability to require the States to govern accord-
ing to Congress’’ instructions.””  New York, 505 U. S., at 


162. Congress may not “”simply commandeer the legisla-
tive processes of the States by directly compelling them to
enact and enforce a federal regulatory program.””  Id.,
at 161 (internal quotation marks and brackets omitted).
Congress effectively engages in this impermissible com-
pulsion when state participation in a federal spending
program is coerced, so that the States’’ choice whether to
enact or administer a federal regulatory program is ren-
dered illusory.

  Where all Congress has done is to “”encourag[e] state
regulation rather than compe[l] it, state governments
remain responsive to the local electorate’’s preferences;
state officials remain accountable to the people.  [But]
where the Federal Government compels States to regulate,
the accountability of both state and federal officials is
diminished.””   New York, supra, at 168.

  Amici who support the Government argue that forcing
state employees to implement a federal program is more
respectful of federalism than using federal workers to
implement that program. See, e.g., Brief for Service Em-
ployees International Union et al. as Amici Curiae in No.
11–-398, pp. 25-–26. They note that Congress, instead of
expanding Medicaid, could have established an entirely
federal program to provide coverage for the same group of
people. By choosing to structure Medicaid as a cooperative
federal-state program, they contend, Congress allows for
more state control. Ibid.

  This argument reflects a view of federalism that our
cases have rejected—-and with good reason. When Con-
gress compels the States to do its bidding, it blurs the
lines of political accountability.  If the Federal Govern-
ment makes a controversial decision while acting on its
own, ““it is the Federal Government that makes the deci-
sion in full view of the public, and it will be federal offi-
cials that suffer the consequences if the decision turns out
to be detrimental or unpopular.””  New York, 505 U. S., at

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