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The Supreme Court’s decision upholding health insurance subsidies for low-income Americans in every state will almost certainly not stop attempts by Republicans to destroy or impede the Affordable Care Act piece by piece. ... there are myriad ways the current Republican Congress, future Congresses or a future Republican president could subvert important elements of the law or render it inoperative. (6/27)

Despite the Supreme Court decision to uphold the subsidies for private insurance in King v. Burwell, the fundamental problems with the Affordable Care Act remain. Ironically, it is the growing government centralization of health insurance at the expense of private insurance that must be addressed. (Scott W. Atlas, 6/28)

Sometimes history speeds up. Rarely in our nation’s 239 years of life has a single week brought such a surge of social change and such a sweeping set of challenges to past assumptions. ... On Thursday, the Supreme Court decided, 6 to 3, to keep the Affordable Care Act whole. To go the other way, as Chief Justice John G. Roberts Jr. rightly argued, would have violated any plausible understanding of what Congress had intended. ... Yet if the King v. Burwell case was about a textual dispute, its implications were much broader. (E.J. Dionne Jr., 6/28)

The Supreme Court’s decision in King v. Burwell is an enormous victory for the Obama administration and the Affordable Care Act. By upholding the provision of subsidies in the 34 states that rely on the federal insurance exchange, the court ensured that 6.4 million Americans would not lose access to affordable coverage. Instead of dealing a devastating blow to Americans with ACA insurance plans, the court handed Obamacare opponents a crushing defeat. The last serious legal challenge to Obamacare is over. ... Yet the ACA in 2015 is not where health-reform supporters envisioned it would be in 2010. Obamacare is a limited law, full of compromises that were necessary to secure its enactment. (Jonathan Oberlander and Eric Patashnik, 6/28)

Chief Justice John Roberts' majority opinion upholding subsidies on the Affordable Care Act's federal exchange is a big gift to Republicans. Though he was ruling against the expressed desire of every Republican presidential candidate -- that the subsidies should be eliminated even if that meant the nation's healthcare system would enter a death spiral -- the chief justice greatly simplified the lives of Republican politicians. In the process, he made a powerful argument for deference to the legislature and the critical need to consider the goals of Congress and real-world consequences when interpreting statutes. By mustering five votes in support of his position, Roberts made a bitter loser of Justice Antonin Scalia and his rigid textualist approach to statutory interpretation. (William Yeomans, 6/26)

Obamacare is dead. Long live Robertscare. With Thursday’s U.S. Supreme Court decision in King v. Burwell, Chief Justice John Roberts, writing for the majority, cemented the Affordable Care Act as the law of the land. Oh, there will still be plenty of legal challenges to it, and there will be an attempt to replace it should a Republican occupy 1600 Pennsylvania Ave. in 2017; but for all intents and purposes, the individual and employer mandates, and now the subsidized federal health insurance exchange, are now in concrete. (Christopher Rants, 6/27)

Many Texas lawmakers have doggedly opposed all aspects of Obamacare since its passage five years ago, perhaps hoping the law would simply go away. But now it is time for the law’s opponents to take a more pragmatic approach and embrace those parts of the law that can help ordinary Texans afford needed medical care. In particular, Texas should take advantage of generous federal matching funds available to states that expand their Medicaid programs to cover people earning up to 138 percent of the federal poverty level, or $33,465 for a family of four. (Sam Richardson, 6/26)

I first posted last January about how the Republicans’ hopes (“plans” would be too strong a term) to repeal Obamacare through reconciliation were, to be polite, highly unlikely to be successful. But events over the past two weeks have made any attempt to use the congressional budget process to repeal or make substantial changes in Obamacare a complete waste of time. (Stan Collender, 6/29)

While many have been awaiting this important decision, we must remember that much remains to be done to assure that all Kentuckians – and all Americans – have timely access to safe, effective and affordable quality care. ... In Kentucky, where more than a half million people have gained insurance through the Affordable Care Act, the work to assure access and improve health continues. Diverse groups of individuals and organizations from across Kentucky continue to work with the state to find ways to continue to improve and protect Kentuckians' health and well-being. Reforming the way we pay for care and making cost and pricing more transparent are under discussion. The state has expanded scope of practice for Advance Practice Registered Nurses. (Susan G. Zepeda, 6/28)

By design, Obamacare relies on Medicaid – the federal health insurance program for the poor – to expand health coverage. Since 2013, more than 11 million people have gained insurance through the federal program, which supports those earning below 133 percent of the federal poverty level. At the same time, there hasn’t been a surge of new or current primary care physicians taking on Medicaid patients. As a result, millions of enrollees can’t access a doctor and have turned to the ER for basic care. The best way to reverse this trend is to redesign how Medicaid is financed. (Sally C. Pipes, 6/28)