The Patient Protection and Affordable Care Act survived yet another legal attack Monday when the U.S. Supreme Court declined to hear a challenge targeting the requirement that adult Americans enroll for coverage or pay a fine.

The challenge had been brought by two medical provider groups: the Alliance for Natural health USA and the Association of American Physicians. It was three strikes and out for the plaintiffs, whose arguments were turned down at the district and federal appellate level prior to filing for a SCOTUS review.

While Republicans have mounted a steady stream of legal challenges to PPACA, so far the Supreme Court has held in favor of the law. But another major thrust is just around the corner.

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