The Supreme Court upheld the insurance subsidies under President Barack Obama’s health care overhaul in a 6-3 ruling Thursday.
The ruling on King v. Burwell leaves the Affordable Care Act unchanged, and protects the subsidies that 8.7 million people receive to make insurance affordable.
"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Chief Justice John Roberts wrote in the court's majority opinion.
Sojourners President Jim Wallis issued a statement on the ruling this morning, saying,
“I am pleased that the Supreme Court has refused to overturn the Affordable Care Act on a technicality. More importantly, I am pleased that the Court chose not to take away health coverage from millions of Americans. Now that this case is behind us, we should renew our focus on successful implementation of the ACA and on the goal of universal coverage.”
In the challengers' view, the phrase "established by the state" demonstrated that subsidies were to be available only available to people in states that set up their own exchanges. Those words cannot refer to exchanges established by the Health and Human Services Department, which oversees healthcare.gov, the opponents argued.
The administration, congressional Democrats and 22 states responded that it would make no sense to construct the law the way its opponents suggested. The idea behind the law's structure was to decrease the number of uninsured. The law prevents insurers from denying coverage because of "pre-existing" health conditions. It requires almost everyone to be insured and provides financial help to consumers who otherwise would spend too much of their paycheck on their premiums.
The point of the last piece, the subsidies, is to keep enough people in the pool of insured to avoid triggering a so-called death spiral of declining enrollment, a growing proportion of less healthy people and premium increases by insurers.
Roberts was joined by Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, Elena Kagan, and Anthony Kennedy in the majority opinion. Justice Antonin Scalia, joined by Clarence Thomas and Samuel Alito, wrote the dissent.
“We should start calling this law SCOTUScare,” Scalia wrote, in an apparent reference to the Supreme Court upholding the Affordable Care Act on two separate occasions.
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