So why is the failure of health-care exceptionalism a defeat for health-care reform, and why did Roberts insist on denying that health insurance is unique? To the first question, the answer is that health care stood a chance of gaining special constitutional status that could have made future health-care reforms easier to pass. The government was asking for extra latitude when regulating the health-care market, and the Supreme Court refused to grant it. For those who believe that the ACA falls short of truly rationalizing American health care, this defeat may prove dramatic. Americans might be in for another 100-year slog. But the answer to the second question ought to provide some comfort to those who, despite wanting a rational health-care system, also want a strong constitutional system. Roberts’ one-size-fits-all approach to the ACA’s constitutionality will save future Supreme Court justices from going down the rabbit hole of asking why the uniqueness of health insurance mattered and whether the uniqueness of some other market ought to matter, too. Importantly, the Supreme Court used to engage in market-specific analysis of commercial regulation, asking whether a given market was so “impressed with a public interest” that its rates could be freely regulated,4 and the result was a colossal mess. By rejecting health-care exceptionalism here, Roberts avoided repeating that history.