Top Court Backs Obamacare, President Says It's Here to Stay

Evan Vucci/APIn upholding subsidies for participants in the Affordable Care Act, the Supreme Court handed President Barack Obama a major victory.
By Lawrence Hurley

WASHINGTON -- The U.S. Supreme Court on Thursday rejected a conservative legal challenge that could have doomed President Barack Obama's health care law, upholding nationwide tax subsidies crucial to his signature domestic policy achievement.

Obama strode into the White House Rose Garden after the ruling to declare that the law known as Obamacare is working, helping millions of Americans afford health insurance who otherwise would have none, and that it is "here to stay."

%VIRTUAL-pullquote-Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.%Chief Justice John Roberts, a conservative appointed by Republican President George W. Bush, wrote in the 6-3 ruling that Congress clearly intended for the tax subsidies that help millions of low- and moderate-income people afford private health insurance to be available in all 50 states.

The court decided that the law did not restrict the subsidies to states that establish their own online health insurance exchanges, as the challengers in the case contended.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Roberts wrote, adding that nationwide availability of the credits is required to "avoid the type of calamitous result that Congress plainly meant to avoid."

Roberts was joined by fellow conservative Justice Anthony Kennedy and the court's four liberal members in a ruling that may ensure Obamacare becomes a lasting element of the nation's social programs.

The ruling means the current system will remain in place, with subsidies available nationwide. If the challengers had won, at least 6.4 million people in at least 34 states would have lost subsidies worth an average of $272 a month.

It marked the second time in three years the high court ruled against a major challenge to the law brought by conservatives. Both rulings were written by Roberts. Unlike the 2012 case, in which the court was split 5-4, Kennedy joined Roberts in the majority this time.

Republicans, who have fought the law since its inception, vowed on Thursday to continue efforts in Congress to repeal it despite appeals from Obama's fellow Democrats for them to stop.

Here to Stay

The law was passed by Democrats in Congress in 2010 over unified Republican opposition.

"After more than 50 votes in Congress to repeal or weaken this law, after a presidential election based in part on preserving or repealing this law, after multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay," Obama said.

"It has changed, and in some cases saved, American lives," Obama added.

The question before the justices was whether a four-word phrase in the expansive law saying subsidies are available to those buying insurance on exchanges "established by the state" has been correctly interpreted by the administration to allow subsidies to be available nationwide.

The exchanges are online marketplaces that allow consumers to shop among competing insurance plans.

Roberts wrote that although the conservative challengers' arguments about the plain meaning of the statute were "strong," the "context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase."

Scalia Dissents

After Chief Justice Roberts announced the decision from the bench, Justice Antonin Scalia read for 11 minutes from his dissenting opinion inside the court's white marble and crimson-draped setting.

Scalia said the statute's words were clear, that Congress wanted to limit the credits to the state exchanges. Scalia recalled the court's 2012 decision narrowly upholding the law, again over his dissent.

"We really should start calling the law SCOTUScare," Scalia said. SCOTUS is the acronym for the Supreme Court of the United States.

"This court has no free-floating power to rescue Congress from its drafting mistakes," Scalia added.

Roberts, sitting next to him on the bench, sat stone-faced. He smiled slightly at the SCOTUScare line, but otherwise betrayed no emotion.

Conservative Justices Clarence Thomas and Samuel Alito joined Scalia's dissent.

Fewer Uninsured

The Obama administration said 16.4 million previously uninsured people have gained health insurance since the law was enacted. There are currently around 26 million Americans without health insurance, according to government figures.

"This is not about the Affordable Care Act as legislation, or Obamacare as a political football. This is health care in America," Obama said.

The top two congressional Republicans denounced the law Thursday. Senate Majority Leader Mitch McConnnell said it makes life "miserable" for many people it purports to help. House of Representatives Speaker John Boehner called it "fundamentally broken."

The court, in another ruling favoring the Obama administration Thursday, also embraced a broad interpretation of the type of discrimination claims that can be made under the landmark Fair Housing Act.

The Obamacare ruling comes as a major relief to Obama as he seeks to ensure that his legacy legislative achievement is implemented effectively and survives political and legal attacks before he leaves office in January 2017.

The U.S. hospital industry also breathed a collective sigh of relief on Thursday and investors cheered that the growing number of paying customers created by Obamacare wouldn't disappear.

Health Stocks Soar

The ruling was a catalyst for a rally in shares of health care providers and insurers, with hospital stocks in particular getting a big boost. Shares of hospital operators Community Health Systems (CYH), HCA Holdings (HCA), Universal Health Services (UHS) and LifePoint Health (LPNT) all hit life-time highs, each rising by 8 percent or more.

"The subsidies upheld today help patients afford health insurance so they can see a doctor when they need one and not have to wait until a small health problem becomes a crisis," said Dr. Steven Stack, president of the American Medical Association.

Conservatives have called Obamacare a government overreach and "socialized medicine." Opponents repeatedly but unsuccessfully sought to repeal it in Congress and launched a series of legal challenges.

The current case started as a long-shot legal challenge by conservative lawyers that oppose the law. Financed by a libertarian Washington group called the Competitive Enterprise Institute, the lawyers recruited four people from Virginia as plaintiffs. The lead plaintiff was a self-employed limousine driver named David King.

The plaintiffs said they were "deeply disappointed" with the ruling. The law "unfairly restricts the health insurance choices of millions of people, and it threatens their jobs as well," they added.

The case is King v. Burwell, U.S. Supreme Court, No. 14-114.

Obamacare Explained Four Ways
See Gallery
Top Court Backs Obamacare, President Says It's Here to Stay
Unfortunately, for all its completeness, the Reddit explanation isn't the most interesting read. If you want something a little more diverting, you may consider taking a peek at Obamacare: Explain It Like I'm Five. Basically, this cartoon explains Obamacare like a playground argument, a he said/she said battle between insurers and average people, with Obama running interference in the middle. As an added plus, the website also lists 24 bullet points covering most of the things that Obamacare will change.
If you want something a bit more scholarly, Obamacare Exchanges Open: The New Law Explained in Seven Easy Steps uses President Obama's own words to explain several main points of the plan, answering questions about how it will affect health care costs, how it will impact small businesses, and the positive effect that it may have on family finances. And, for those who like bullet points, the White House has put together a list of their own.
Speeches and bullet points and detailed explanations are all well and good, but if you're one of those people who likes to get their weighty explanations with a spoonful of sugar, The Henry J. Kaiser Family Foundation's new video, "The Youtoons Get Ready for Obamacare" does a great job of explaining most of the ins and outs of the new law. It's hard to find a better ground-level understanding of how the new law will affect your life.
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