- In a massive victory for President Obama's signature healthcare law, the Supreme Court on Thursday ruled to uphold federal subsidies in King v. Burwell. The final ruling was six to three in favor of the administration.
- Had the Supreme Court ruled against the government in this case, subsidies would have be cut off for those who live in states with federal, rather than state exchanges.
- According to the Kaiser Family Foundation, this could have resulted in a loss of subsidies for more than 7.5 million people, the majority of which would not be able to afford health insurance without the subsidies.
The six were Roberts, Kennedy, Ginsburg, Breyer, Sotomayor and Kagan. The three dissenters were Scalia, Alito and Thomas.
"In every case we must respect the role of the Legislature, and take care not to undo what it has done," Chief Justice Roberts wrote in his opinion. "A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter."
In his dissent, Scalia stood by a literal interpretation of the law, writing: "Words no longer have meaning if an Exchange that is not established by a State is 'established by the state.'"
Of the approximately 10.2 million consumers who had effectuated Marketplace enrollments at the end of March 2015, 85% or about 8.7 million consumers were receiving an advanced premium tax credit to make their premiums more affordable. Had the decision gone to the plaintiffs, according to Kaiser, the loss of subsidies would have destabilized the individual insurance markets in states with federal exchanges because insurers would have still been required to guarantee access to coverage regardless of health status. They would also still have been prohibited from charging sick people more than healthy people, resulting in substantial premium increases.
Want to read more? Here's what the healthcare industry is saying about the decision.