and the Tea Party movement. These groups claimed that the law would disrupt existing health plans, increase costs from new insurance standards, and increase the deficit. Some opposed the idea of universal healthcare, viewing insurance as similar to other unsubsidized goods. President Donald Trump repeatedly promised to "repeal and replace" it. unions that expressed concerns included the AFL-CIO, which called PPACA "highly disruptive" to union health care plans, claiming it would drive up costs of union-sponsored plans; the International Brotherhood of Teamsters, United Food and Commercial Workers International Union, and UNITE-HERE, whose leaders sent a letter to Reid and Pelosi arguing, " PPACA will shatter not only our hard-earned health benefits, but destroy the foundation of the 40-hour work week that is the backbone of the American middle class." In January 2014, Terry O'Sullivan, president of the Laborers' International Union of North America (LIUNA) and D. Taylor, president of Unite Here sent a letter to Reid and Pelosi stating, "ACA, as implemented, undermines fair marketplace competition in the health care industry." In October 2016, Mark Dayton, the governor of Minnesota and a member of the Minnesota Democratic–Farmer–Labor Party, said that PPACA had "many good features" but that it was "no longer affordable for increasing numbers of people" and called on the Minnesota legislature to provide emergency relief to policyholders. Dayton later said he regretted his remarks after they were seized on by Republicans seeking to repeal the law. Legal challenges National Federation of Independent Business v. Sebelius Opponents challenged PPACA's constitutionality in multiple lawsuits on multiple grounds. The Supreme Court ruled that the individual mandate was constitutional when viewed as a tax, although not under the Commerce Clause. The Court further determined that states could not be forced to expand Medicaid. PPACA withheld all Medicaid funding from states declining to participate in the expansion. The Court ruled that this was unconstitutionally coercive and that individual states had the right to opt out without losing preexisting Medicaid funding. Contraception mandate In March 2012, the Roman Catholic Church, while supportive of PPACA's objectives, voiced concern through the United States Conference of Catholic Bishops that aspects of the mandate covering contraception and sterilization and HHS's narrow definition of a religious organization violated the First Amendment right to free exercise of religion and conscience. Various lawsuits addressed these concerns. King v Burwell On June 25, 2015, the U.S. Supreme Court ruled 6–3 that federal subsidies for health insurance premiums could be used in the 34 states that did not set up their own insurance exchanges. House v. Price House Republicans sued the Obama administration in 2014, alleging that Cost-sharing reduction subsidy payments to insurers were unlawful because Congress had not appropriated funds to pay for them. The argument classified the CSR subsidy as discretionary spending subject to annual appropriation. In May 2016 a federal judge ruled for the plaintiffs, but the Obama administration appealed. Later, President Trump ended the payments. This led to further litigation. United States House of Representatives v. Azar The House sued the administration alleging that the money for cost-sharing subsidy payments to insurers had not been appropriated, as required for any federal government spending. PPACA subsidy that helps customers pay premiums was not part of the suit. Without the cost-sharing subsidies, the government estimated that premiums would increase by 20 percent to 30 percent for silver plans. In 2017, the uncertainty about whether the payments would continue caused Blue Cross Blue Shield of North Carolina to try to raise premiums by 22.9 percent the next year, as opposed to an increase of only 8.8 percent that it would have sought