Crime & Justice

Affordable Care Act: Supreme Court upholds nationwide health care law subsidies

U.S. President Barack Obama (R), flanked by Vice President Joe Biden (L), gives a statement on the Supreme Court health care decision in the Rose Garden at the White House on June 25, 2015 in Washington, DC. The Supreme Court upheld the Obama health care subsidies in a 6-3 ruling.
U.S. President Barack Obama (R), flanked by Vice President Joe Biden (L), gives a statement on the Supreme Court health care decision in the Rose Garden at the White House on June 25, 2015 in Washington, DC. The Supreme Court upheld the Obama health care subsidies in a 6-3 ruling.
Alex Wong/Getty Images

Updated 10:32 a.m.: Ruling significant for many states, if not California

Peter Lee, Executive Director of Covered California, praised Chief Justice Roberts for his "deep understanding of what the Affordable Care Act" is all about.

His comments followed a Supreme Court ruling that upheld a key part of the Obama administration's health care overhaul — the nationwide tax subsidies that 8.7 million people currently receive to make insurance affordable.

California Senator Barbara Boxer echoed Lee's sentiment.

"I think that the decision is so elegant in its simplicity. It basically says, 'We know what Congress meant to do, and therefore even though there were some inartful parts in the way they were written in the law, the main thing is Congress meant every middle-class family to be able to have tax credits if they needed it to get affordable health care,'" she said.

Lee said a ruling that had gone the other way would have had a "negligible" impact on California, since the state runs its own health exchange.

But for states without such exchanges, the ruling was significant.

"And if it had gone the other way, Obamacare, this affordable health care act, would definitely have crumbled," Boxer told KPCC's Take Two on Thursday.

— KPCC staff

Updated 8:53 a.m.: Obama says health law is 'here to stay'

President Barack Obama said Thursday his signature health care law "is here to stay" and said it was "a good day for America" shortly after the Supreme Court upheld the law's nationwide tax subsidies.

The ruling preserves health insurance for millions of Americans.

Video: Obama speaks on the Supreme Court decision

The president noted the multiple challenges to the law, both in Congress and the courts. But he said the law is no longer about politics, but is about the benefits it is having on extending coverage to Americans and making health insurance more affordable.

Obama said that while there is still work to be done to make health care in the U.S. better, "this law is working."

Still, the legal fight over the health care overhaul is not over.

At least four issues related to the law are still being sorted out in the courts. None, though, seems to pose the same threat as the challenge to nationwide health plan subsidies that the Supreme Court now has rejected.

Among pending lawsuits: House Republicans are challenging some $175 billion the administration is paying health insurance companies over a decade to reimburse them for offering lowered rates for poor people. The House argues that Congress never specifically appropriated that money.

As well, dozens of religiously affiliated institutions do not like compromises the administration has put forward to allow women covered under these institutions' health plans to obtain contraceptives at no extra cost, while respecting religious objections to providing contraceptives.

Four federal appeals courts have sided with the administration on this issue, but other cases are pending and Catholic organizations in Pennsylvania have asked the Supreme Court to decide the matter.

— Associated Press

8:27 a.m.: Supreme Court upholds nationwide health care law subsidies

The Supreme Court on Thursday upheld the nationwide tax subsidies under President Barack Obama's health care overhaul, in a ruling that preserves health insurance for millions of Americans.

The justices said in a 6-3 ruling that the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live, under the 2010 health care law.

The outcome is the second major victory for Obama in politically charged Supreme Court tests of his most significant domestic achievement.

Chief Justice John Roberts again voted with his liberal colleagues in support of the law. Roberts also was the key vote to uphold the law in 2012. Justice Anthony Kennedy, a dissenter in 2012, was part of the majority on Thursday.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Roberts wrote in the majority opinion.

Nationally, 10.2 million people have signed up for health insurance under the Obama health overhaul. That includes the 8.7 million people who are receiving an average subsidy of $272 a month to help pay their insurance premiums.

Of those receiving subsidies, 6.4 million people were at risk of losing that aid because they live in states that did not set up their own health insurance exchanges.

The challenge devised by die-hard opponents of the law, often derided by critics as "Obamacare," relied on four words — established by the state — in the more than 900-page law.

The law's opponents argued that the vast majority of people who now get help paying for their insurance premiums are ineligible for their federal tax credits. That is because roughly three dozen states opted against creating their own health insurance marketplaces, or exchanges, and instead rely on the federal to help people find coverage if they don't get insurance through their jobs or the government.

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, 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.

Several portions of the law indicate that consumers can claim tax credits no matter where they live. No member of Congress said that subsidies would be limited, and several states said in a separate brief to the court that they had no inkling they had to set up their own exchange for their residents to get tax credits.

The 2012 case took place in the midst of Obama's re-election campaign, when he touted the largest expansion of the social safety net since the advent of Medicare nearly a half-century earlier. But at the time, the benefits of the Affordable Care Act were mostly in the future. Many of its provisions had yet to take effect.

In 2015, the landscape has changed, although the partisan and ideological divisions remain for a law that passed Congress in 2010 with no Republican votes.

The case is King v. Burwell, 14-114.

— Mark Sherman/Associated Press

This story has been updated.