U.S. Citizens Association v. Kathleen Sebeliux, 2013 U.S. App. LEXIS 2245

USCA and two members challenge PPACA's individual mandate requiring health insurance or a shared responsibility payment.
Plaintiffs sue Secretary Sebelius, and federal officials; district court dismissed Counts Two–Four but left Count One (Commerce Clause) for summary judgment.
District court later certified a partial Rule 54(b) judgment allowing immediate appeal on Counts Two–Four, and final judgment on Count One; this court consolidated appeals.
Supreme Court decision in NFIB v. Sebelius controls Count One, holding the mandate is a valid exercise of Congress's taxing power.
The court examines Counts Two–Four as to intimate association, expressive association, liberty, and privacy claims, all of which are dismissed for failure to state a claim.
Rule 54(b) certification was proper, giving this court jurisdiction to review the three counts plus Count One on appeal.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Commerce Clause validity post-NFIB	Mandate violates Commerce Clause as intrusive regulation.	Mandate valid under taxing power per NFIB.	Count One upheld; mandate constitutional as tax.
Intimate association rights	Mandate infringes doctor–patient intimacy rights of USCA members.	No intimate association with physicians protected in this context; mandate affects insurance, not relationships.	Plaintiffs fail to show protected intimate association; claim dismissed.
Expressive association rights	Mandatory insurance membership burdens group expression and association.	Mandate does not prevent expressive association or force particular members.	No significant burden on expressive association; claim dismissed.
Liberty interests under due process	Rights to refuse unwanted medical care and to avoid paying for unwanted coverage are fundamental.	Liberty rights here are not fundamental; tax or mandate does not violate due process.	Right to liberty not fundamental as claimed; claim dismissed.
Right to privacy of medical information	Government disclosures to insurers/private entities violate privacy.	Payment option avoids privacy concerns; disclosures are permissible and not enforced against individuals.	Privacy claim unpersuasive; claim dismissed.

National Federation of Independent Business v. Sebelius, 132 S. Ct. 2566 (2012) (upholds tax power to require insurance or pay penalty)
Planned Parenthood Sw. Ohio Region v. DeWine, 696 F.3d 490 (6th Cir. 2012) (analyze Rule 54(b) treatment of multiple constitutional claims)
Rumsfeld v. Forum for Academic and Institutional Rights, Inc., 547 U.S. 47 (2006) (expressive association framework)
Roberts v. U.S. Jaycees, 468 U.S. 609 (1984) (intimate association protective framework)
Washington v. Glucksberg, 521 U.S. 702 (1997) (fundamental rights must be deeply rooted in history)