they will take everything from you, as long as they believe they can get away with it

3. Alternative Options Not Explored:

4. Out-of-Network Care:

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Sincerely and in good health, United Healthcare

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President Barack Obama stated that the decision "gives the special interests and their lobbyists even more power in Washington, while undermining the influence of average Americans who make small contributions to support their preferred candidates". Obama later stated that "this ruling strikes at our democracy itself" and "I can't think of anything more devastating to the public interest". Just days after the ruling, Obama condemned the decision during his 2010 State of the Union Address, stating that, "Last week, the Supreme Court reversed a century of law to open the floodgates for special interests, including foreign corporations, to spend without limit in our elections. Well, I don't think American elections should be bankrolled by America's most powerful interests, or worse, by foreign entities." On television, the camera shifted to a shot of the Supreme Court Justices in the front row directly in front of the President while he was making this statement, and Justice Samuel Alito mouthed the words "Not true".

Democratic Senator Russ Feingold, a lead sponsor of the BCRA, stated "This decision was a terrible mistake. Presented with a relatively narrow legal issue, the Supreme Court chose to roll back laws that have limited the role of corporate money in federal elections since Teddy Roosevelt was president." Representative Alan Grayson stated that it was "the worst Supreme Court decision since the Dred Scott case, and that the court had opened the door to political bribery and corruption in elections to come. Senator John McCain, a co-crafter of the BCRA, said "there's going to be, over time, a backlash... when you see the amounts of union and corporate money that's going to go into political campaigns". McCain was "disappointed by the decision of the Supreme Court and the lifting of the limits on corporate and union contributions" but not surprised by the decision, saying that "It was clear that Justice Roberts, Alito and Scalia, by their very skeptical and even sarcastic comments, were very much opposed to BCRA."

Consumer activist Ralph Nader condemned the ruling, saying that "With this decision, corporations can now directly pour vast amounts of corporate money, through independent expenditures, into the electoral swamp already flooded with corporate campaign PAC contribution dollars." When discussing the ruling and related developments, former President Jimmy Carter called the United States "an oligarchy with unlimited political bribery" in an interview with Thom Hartmann. Retired Supreme Court Justice Sandra Day O'Connor, whose opinions had changed from dissenting in Austin v. Michigan State Chamber of Commerce to co-authoring (with Stevens) the majority opinion in McConnell v. FEC twelve years later, criticized the decision only obliquely, but warned, "In invalidating some of the existing checks on campaign spending, the majority in Citizens United has signaled that the problem of campaign contributions in judicial elections might get considerably worse and quite soon."

Constitutional law scholar Laurence H. Tribe wrote that "talking about a business corporation as merely another way that individuals might choose to organize their association with one another to pursue their common expressive aims is worse than unrealistic; it obscures the very real injustice and distortion entailed in the phenomenon of some people using other people's money to support candidates they have made no decision to support, or to oppose candidates they have made no decision to oppose." Cass Sunstein of Harvard University listed Citizens United as the "worst Supreme Court decision since 1960", noting that the decision is "undermining our system of democracy itself."

The New York Times stated in an editorial, "The Supreme Court has handed lobbyists a new weapon. A lobbyist can now tell any elected official: if you vote wrong, my company, labor union or interest group will spend unlimited sums explicitly advertising against your re-election." Jonathan Alter called it the "most serious threat to American democracy in a generation". The Christian Science Monitor wrote that the court had declared "outright that corporate expenditures cannot corrupt elected officials, that influence over lawmakers is not corruption, and that appearance of influence will not undermine public faith in our democracy".

Critics predicted that the Citizens United ruling would "bring about a new era of corporate influence in politics", allowing companies to "buy elections" to promote their financial interests. Instead, large expenditures, usually through "Super PACS", have come from "a small group of billionaires", based largely on ideology. The New York Times asked seven academics to opine on how corporate money would reshape politics as a result of the court's decision. Three wrote that the effects would be minimal or positive: Christopher Cotton wrote that "There may be very little difference between seeing eight ads or seeing nine ads... And, voters recognize that richer candidates are not necessarily the better candidates, and in some cases, the benefit of running more ads is offset by the negative signal that spending a lot of money creates. Eugene Volokh stated that the "most influential actors in most political campaigns" are media corporations which "overtly editorialize for and against candidates, and also influence elections by choosing what to cover and how to cover it". Holding that corporations like Exxon would fear alienating voters by supporting candidates, the decision really meant that voters would hear "more messages from more sources".

According to a 2020 report from OpenSecrets, between 2010 and 2020, the ten largest donors and their spouses spent a total of $1.2 billion on federal elections. In the 2018 elections, this group accounted for around 7% of all election-related giving, up from less than 1% a decade prior. Over the decade, election-related spending by non-partisan independent groups jumped to $4.5 billion, whereas from 1990 to 2010 the total spending under that category was just $750 million. Outside spending surpassed candidate spending in 126 races since the ruling compared to only 15 in the five election cycles prior. Groups that did not disclose their donors spent $963 million in the decade following the ruling, compared to $129 million in the decade prior. Non-partisan outside spending as a percentage of total election spending increased from 6% in 2008 to nearly 20% in 2018. During the 2016 election cycle, Super PACs spent more than $1 billion, nearly twice that of every other category of contributors combined. In 2018, over 95% of super PAC money came from the top 1% of donors.

Citizens United has often been credited for the creation of Super PACs -- political action committees that make no direct financial contributions to candidates or parties but instead spend money on advertising, and can in turn accept unlimited contributions from individuals, corporations, and unions. According to a 2021 study, the ruling weakened political parties while strengthening single-issue advocacy groups and Super PACs funded by billionaires with pet issues. The ruling made it easier for self-promoting politicians to undermine political processes and democratic norms to promote themselves by soliciting funds from such committees.

Citizens United also allowed incorporated 501(c)(4) public advocacy groups (such as the National Rifle Association of America, the Sierra Club, or Citizens United itself) to make expenditures in political races. Such groups may not, under the tax code, have a primary purpose of engaging in electoral advocacy but they can advertise on behalf of larger political issues. A number of partisan organizations such Crossroads Grassroots Policy Strategies and 21st Century Colorado have since registered as tax-exempt 501(c)(4) groups and have engaged in substantial political spending. This has led to claims of large secret donations, and questions about whether such groups should be required to disclose their donors, which they were required to do before the Citizens United ruling.

While the long-term legacy of the ruling remains to be seen, studies by political scientists have concluded that Citizens United worked in favor of the electoral success of Republican candidates. One study by the University of Chicago, Columbia University, and the London School of Economics found "that Citizens United increased the GOP's average seat share in the state legislature[s] by five percentage points. That is a large effect -- large enough that, were it applied to the past twelve Congresses, partisan control of the House would have switched eight times." A 2016 study in The Journal of Law and Economics found "that Citizens United is associated with an increase in Republicans' election probabilities in state house races of approximately 4 percentage points overall and 10 or more percentage points in several states. We link these estimates to on-the-ground evidence of significant spending by corporations through channels enabled by Citizens United."