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San Francisco Marin Medical Society Blog

Supreme Court Upholds ACA Subsidies



The U.S. Supreme Court upheld a key provision of the Affordable Care Act (ACA), reaffirming that 6.4 million people in 34 states can continue to receive subsidies to purchase health care insurance. In a 6-3 ruling, the nation’s highest court ruled that critics’ reading of Obamacare might make sense in isolation, but not when viewed in a larger context and in light of the intention of the law.

The question in the case, King v. Burwell, was what to make of a phrase in the law that seems to say the subsidies are available only to people buying insurance on “an exchange established by the state.

Chief Justice John Roberts and Justice Anthony Kennedy joined the court’s four Democratic appointees in the majority, affirming that Congress’ intent was to allow tax credits in all 50 states, not just the 16 that have authorized their own online insurance exchanges.

The case arrived at the Supreme Court after a 4th U.S. Circuit Court of Appeals panel in Virginia in July 2014 unanimously ruled in favor of the administration, saying subsidies should be allowed in all 50 states. This case marks the law’s third trip to the high court. In 2012, Chief Justice Roberts joined the four more liberal justices to uphold the constitutionality of the ACA, with four conservative justices dissenting. Earlier, Chief Justice Roberts and the four conservative justices carved out an exception to providing contraceptive coverage for employers who object on religious grounds.

The case does not directly affect California, as it is among the 16 states that established its own insurance exchange. However, the Court’s affirmation of the ACA serves to bolster California efforts to fully implement federal health care reform. The landmark decision also affirms SFMS and CMA’s policy and actions to stand behind the ACA while recognizing the law is not perfect and working towards fixing problems.

Click here to read SCOTUS ruling and opinions.



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