The nation’s healthcare and environmental laws share some common features. Both require individuals to participate in certain markets, are steeped in the principles of cooperative federalism, and attach federal dollars to compliance. Thus, the Supreme Court’s decision in National Federation of Independent Business v. Sebelius has the potential to influence the nation’s federal environmental laws in new ways. First, the logical, if attenuated, extension of the Court’s conclusion that the Commerce Clause does not permit Congress to compel individuals to purchase health insurance suggests some limits on the extent to which Congress may compel participation in certain pollution-control and abatement markets. Second, the Court’s decision that Congress cannot “compel” states to adopt the Medicaid extension under the threat of losing all Medicaid funding suggests further limits on the extent to which Congress may withhold funding from states that do not or cannot implement federal environmental laws. Lastly, the basis for upholding the individual mandate as a tax actually has the potential to provide additional constitutional justification for federal environmental laws should the Court ever reconsider their Commerce Clause foundations. Nonetheless, the Sebelius opinion is unlikely to have a significant impact on federal environmental laws because they can be effectively distinguished from the Court’s healthcare ruling.