ACA challenge rejected by U.S. Supreme Court

2014 07 23 09 50 58 820 Affordable Care Act Aca 200

The Patient Protection and Affordable Care Act (ACA) has survived another U.S. Supreme Court test.

At stake in the ruling was whether subsidies would continue in more than 30 states for those who purchased healthcare insurance through the federal government's online health insurance exchange, known as the Health Insurance Marketplace.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Chief Justice John Roberts Jr. wrote in the majority opinion for the King v. Burwell case.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them”
— Chief Justice John Roberts Jr.

"Here, the statutory scheme compels us to reject petitioners' interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very 'death spirals' that Congress designed the Act to avoid," he wrote.

A key question brought before the Supreme Court was how the phrase "an Exchange established by the State" should be interpreted. The petitioners argued it should be interpreted literally and exclude federal involvement.

However, Justice Roberts disagreed with that argument in the decision.

"After reading Section 36B along with other related provisions in the Act, we cannot conclude that the phrase 'an Exchange established by the State under [Section 18031]' is unambiguous," he wrote.

In a statement to, ADA said the decision maintains the status quo for millions of people in the 34 states with federally facilitated health plan marketplaces. The association said it believes the decision will not affect the dental coverage of those currently covered under these programs.

Tevi Troy, president of the American Heath Policy Institute (AHPI), said in a statement that this isn't the end of the discussion about the ACA.

"We will continue to see a lot of discussion on the ACA leading up to the 2016 presidential election. ... Either way, the climate may be ripe for ACA changes in 2017, regardless of which party wins the White House," Troy said.


Writing the dissenting opinion, Justice Antonin Scalia said legal interpretation was superseded by politics.

"Under all the usual rules of interpretation, in short, the Government should lose this case," he wrote. "But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved."

Roberts was joined by Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonya Sotomayor, and Elena Kagan in the majority. Scalia and Justices Clarence Thomas and Samuel Alioto Jr. dissented.

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