Supreme Court Rules Obamacare Subsidies Are Legal

The Supreme Court has 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 Thursday 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.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," the court's majority said in the opinion, which was written by Chief Justice John Roberts. But they acknowledged that "petitioners' arguments about the plain meaning ... are strong."

Roberts was joined by the court's liberal justices, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan, as well as Anthony Kennedy, the swing vote.

As NPR's Nina Totenberg reported in March, opponents of the law contended "that the text of the law does not authorize subsidies to make mandated insurance affordable in 34 states."

 At issue were six words in one section of the law. As Totenberg pointed out: "Those words stipulate that for people who cannot afford health coverage, subsidies are available through 'an exchange established by the state.'" She added:

"The government [contended] that those words refer to any exchange, whether it is set up by the state itself or an exchange run for the state by the federal government in accordance with individual state insurance laws and regulations. The challengers [said] the statute means what it says and no more."

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

More than 230,000 Illinois residents could have lost the tax credits that help them pay for coverage if the court had ruled the other way.  On average, consumers would have seen their
premiums increase by 169 percent if the tax credits were no longer available, according to the nonpartisan Kaiser Family Foundation. The group estimated about 160,000 low-and moderate-income Indiana residents will keep the health insurance premium subsidies.
 
Obama, commenting on the ruling today, said after numerous challenges, the Affordable Care Act is "woven into the fabric" and "here to stay." 

"Five years ago, after nearly a century of talk, decades of trying and bipartisan debate," the law is finally and firmly entrenched, Obama said, speaking from the White House Rose Garden.

Healthcare, he said is "not a privileged for a few, but a right for all." He said that the law had endured "successes and setbacks. The setbacks I remember clearly."

The decision comes three years after a bitterly divided high court upheld the Affordable Care Act as constitutional by a 5-to-4 vote. 

Reaction In Illinois

Democratic U.S. Senator Dick Durbin of Illinois issued a statement after the ruling.

"America will not return to the days when millions were uninsured and the cost of health care was out of control," he said.  "The Supreme Court’s decision is the right one for America’s economic future, and for families and businesses in Illinois and across the country."

But Republican Congressman Rodney Davis said the high court's decision doesn't change the fact health care premiums continue to rise for millions of Americans, and businesses remain reluctant to grow under the health care law.

“This decision just means we will need to fight harder for the American people to make commonsense changes to this burdensome law. I will continue to push for reforms like my Hire More Heroes Act, to encourage the hiring of more veterans, and other patient-centered reforms that lower overall costs and increase coverage without limiting choices.”

Indiana Republican Gov. Mike Pence says the Supreme Court decision has disappointed those who wanted a fresh start on health care.
 
In a statement, he says, "ObamaCare must be repealed and states must be given the flexibility to craft market-based solutions focused on lowering the cost of health care rather than growing the size of government.  It now falls to the American people to elect new leadership in Washington,'' that will repeal the overhaul.

Groups representing Illinois doctors and hospitals are applauding the high court's decision.
 
Illinois State Medical Society President Dr. Scott Cooper says Thursday's ruling "provides important peace of mind for thousands of Illinois patients'' who buy insurance through HealthCare.gov.
 
Illinois Hospital Association President Maryjane Wurth says the subsidies make insurance affordable to thousands of allow low- and moderate-income Illinoisans.
 
Reaction also came from Land of Lincoln Health, a not-for-profit health plan that covers more than 40,000 Illinoisans. Land of Lincoln Health President Jason Montrie says "all Americans have the right to access affordable, high-quality health insurance.''  He says the subsidies help many Illinois citizens meet their essential health care needs.