The Affordable Care Act just survived a potentially fatal heart attack.
In a major decision, the Supreme Court on Thursday ruled 6-3 that the federal subsidies that help nearly 6.4 million people pay for their Affordable Care Act health plans are legal under the Affordable Care Act.
The ruling avoids what many analysts predicted would be a nightmare scenario had the plaintiffs won: individual plan insurance prices skyrocketing in 34 states and the loss of health coverage for upwards of 8 million people in those states served by the federal insurance marketplace HealthCare.gov as of next year.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John Roberts wrote in the majority decision.
In its ruling in the case known as King v. Burwell, the high court accepted the administration’s argument that the ACA allows federal tax credits to be issued to people who buy health plans through the federally run Affordable Care Act exchange.
Joining the conservative Roberts in the majority decision were Justice Anthony Kennedy, as well as liberal justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan.
The Supreme Court decision is a huge victory for the administration of President Barack Obama and his landmark health-reform law, which was designed to significantly reduce the number of Americans without health coverage.
“The Affordable Care Act is here to stay,” Obama said from the White House Rose Garden after the ruling. “Today is a victory for hardworking Americans all across the country.”
Rep. Nancy Pelosi of California, the Democratic leader in the U.S. House of Representatives, said, “It is long past time for Republicans to abandon their assault on the new-found health security that the Affordable Care Act is providing millions and millions of Americans across the country.”
Timothy Jost, a leading Affordable Care Act expert and law professor at Washington and Lee University, said, “With today’s decision, the ACA has survived yet another near-death experience. The court decisively held that the intent of Congress to authorize federally facilitated marketplaces to grant tax credits is clear once the statute is read as a whole, as the court has always said statutes should be read. ”
“With today’s decision upholding the IRS rule giving all Americans access to premium tax credits, millions of Americans can breath easier today knowing that their access to health care is no longer at risk,” Jost said.
Conservative Justice Antonin Scalia, in his dissent, called the majority decision “absurd.” He wrote that Roberts’ opinion “changes the usual rules of statutory interpretation for the sake of the Affordable Care Act.”
“It rewrites the law to make the tax credits available everywhere,” said Scalia in his dissent, which he read from the bench. “We should start calling this law SCOTUSCare.” Scalia was joined in his dissent by justices Clarence Thomas and Samuel Alito.
And House Speaker John Boehner, R-Ohio, said, “Obamacare is fundamentally broken, increasing health care costs for millions of Americans. Today’s ruling doesn’t change that fact.”
“Republicans will continue to listen to American families and work to protect them from the consequences of Obamacare. And we will continue our efforts to repeal the law and replace it with patient-centered solutions that meet the needs of seniors, small business owners, and middle-class families.”
Michael Cannon, the libertarian CATO Institute’s director of health policy studies, and one of the primary intellectual architects of the challenge to the subsidies, suggested the decision was based on cowardice.
“Today the Supreme Court allowed itself to be intimidated,” Cannon said. “Afraid that Obamacare as written would throw the sickest patients out of their health plans a second time, the court rewrote Obamacareto save it—again. In doing so, the Court has sent a dangerous message to future administrations: If you are going to violate the law, make sure you go big.”
“The Court today validated President Obama’s massive power grab, allowing him to tax, borrow, and spend $700 billion that no Congress ever authorized,” Cannon said, referring to the cost of the subsidies over time. “This establishes a precedent that could let any president modify, amend, or suspend any enacted law at his or her whim.”