Today, an estimated 6.4 million people learned that their health insurance would not be disrupted, after the U.S. Supreme Court handed down another landmark victory for President Obama's Affordable Care Act.

In a 6-3 decision in King v. Burwell, written by Chief Justice John Roberts, the Court ruled that the use of federal subsidies in state exchanges across the nation is lawful. The opinion is here.

The practical effect of the June 25 ruling is that an estimated 6.4 million people who now receive health insurance subsidized by the federal government will not have their coverage threatened. The ruling also means that supporters of the Affordable Care Act can breathe a sigh of relief, as least for the moment, as the law faces no other immediate legal challenges.

"The Affordable Care Act is here to stay," said President Obama, in a statement that marked the importance of today's decision.

The Obama administration, health insurance companies and the Catholic Health Association, an industry lobby that represents church-affiliated hospitals, had expressed fears that a decision against the use of such subsidies for residents in some states could result in a broader disruption of health insurance coverage as consumers walked away from more expensive premiums, leaving a larger percentage of older and sicker patients in some marketplaces.

Thus, the Catholic Health Association's Sister Carol Keehan applauded today's decsion. 

Read The New York Times' breaking news coverage here.  

Writing for the majority, Chief Justice Roberts appeared to take those warnings seriously. While he acknowledged that the  plaintiffs challenging the use of federal subsidies had a "point," he concluded, "The combination of no tax credits and an ineffective coverage re­quirement could well push a State's individual insurance market into a death spiral. It is implausible that Congress meant the [Affordable Care] Act to op­erate in this manner." 

An initial post by Jonathan Keim at National Review's Bench Memos took note of the dissenters' harsh judgment of the majority opinion. Elsewhere on NRO, we learn of Justice Scalia's scathing indictment of Roberts' legal reasoning:

Justice Antonin Scalia said President Obama’s signature domestic policy achievement should be called “SCOTUScare” rather than Obamacare, in light of how many times Chief Justice John Roberts has intervened to protect the law from a crippling legal defeat. Scalia argued that Roberts rewrote the law twice in 2012, and has now done so a third time in his King decision, which allows the IRS to continue providing subsidies to people who purchase insurance in the federal government’s health-care exchange.

[Scalia concluded] “And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”


A ruling against the provision of federal subsidies threatened the survival of the president's signature legislation, and would have provided an immediate opening for the GOP-controlled Congress to offer its own fix to secure coverage for vulnerable consumers. Republicans on Capitol Hill have vowed to repeal Obamacare and replace it with a different framework.

Before the Court issued the ruling, Congressman Paul Ryan, R-Wis., the chairman of the House Ways and Means Committee,  told The Times: “This is the beginning of the end of the Affordable Care Act.”

During  that interview, Ryan outlined a plan that would extend coverage until 2017 for consumers affected by the decision. After Obama left office, Ryan predicted, GOP lawmakers "would try to work with the new president to fully dismantle the health care law and replace it with a more conservative approach."

Meanwhile, NPR reported today that legislative activity at the state level would continue.

In King v. Burwell, the Court was asked to rule on the meaning of a phrase that appeared to limit the federal subsidies to people buying insurance on “an exchange established by the state.” More than thirty states did not establish such exchanges, but individuals in those states applied for health insurance through exchanges established and run by the federal government.

Four plaintiffs from Virginia had filed suit, arguing that the Internal Revenue Service rule, which permitted the use of the federal subsidies, violated  a provision of the Affordable Care Act, which authorized the creation of the health insurance exchanges.

Stay tuned for more Register coverage of this decision.