*The Supreme Court sided Thursday with the White House in a critical Obamacare case, ruling that the law’s health insurance subsidies can continue to flow to residents of states that are using HealthCare.gov.
The 6-3 decision in King v. Burwell preserves the structure of the Affordable Care Act and delivers a second major blow to Republican-backed attempts to undercut the president’s domestic policy legacy.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John Roberts wrote for the court.
Roberts was joined by the court’s four liberal justices: Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan and frequent swing justice Anthony Kennedy, who voted in 2012 to strike the law’s individual mandate.
The high court ruled that the health care law as written does allow residents of states using the federal insurance exchange to receive premium subsidies for their coverage – an outcome that preserves subsidies for 6.4 million people. The court rejected the challengers’ claims that the law was designed to encourage states to operate an exchange by withholding subsidies but mandating insurers to operate under a new set of stringent rules, including the requirement to cover sick customers.
“It is implausible that Congress meant the Act to operate in this manner,” the majority of the justices wrote. “Congress made the guaranteed issue and community rating requirements applicable in every State in the Nation. But those requirements only work when combined with the coverage requirement and the tax credits. So it stands to reason that Congress meant for those provisions to apply in every state as well.”
A ruling against the Obama administration would have eliminated the subsidies in the 34 states – including pivotal 2016 presidential battlegrounds such as Florida, Wisconsin and Ohio – that refused to set up an insurance exchange. The Urban Institute estimated that more than 8.2 million people would be uninsured as a result, a number with the potential for dramatically destabilizing insurance markets.
The dissenting justices said that the law clearly says that the subsidies should be limited. Justice Antonin Scalia even suggested that the court “rewrote” the law and “we should start calling this law SCOTUScare,” which drew a smirk from Roberts.
“Words no longer have meaning if an Exchange that is not established by a State is ‘established by the State,’” Justice Antonin Scalia wrote in a sharply worded dissent that was joined by Justices Clarence Thomas and Samuel Alito. Scalia read much of his dissent from the bench after Roberts read his majority opinion.
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