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Kaiser Health News: High Court Upholds Health Law Subsidies

The Affordable Care Act made it through its second do-or-die Supreme Court test in three years, raising odds for its survival but by no means ending the legal and political assaults on it five years after it became law. The 6-3 ruling, a major win for the White House, stopped a challenge that would have erased tax-credit subsidies in at least 34 states for individuals and families buying insurance through the federal government’s online marketplace. Such a result would have made coverage unaffordable for millions and created price spirals for those who kept their policies, many experts predicted. (Hancock, 6/25)

The case turned on whether the law’s wording allowed for federal subsidies to help lower-income Americans nationwide buy insurance. A contrary ruling could have stripped coverage from millions by making their plans too costly. And it would have thrown the insurance and medical industries into turmoil as the 2016 presidential race heats up. Insurance and hospital businesses, which were preparing for disruptions to the health-care system if the government lost, breathed a sigh of relief and stocks in the companies rose. (Bravin and Radnofsky, 6/25)

The ruling is a crucial win for the Democratic White House, now that Republicans control the House and Senate. Had the high court ruled for the conservative challengers, it would have put the fate of the law in the hands of GOP leaders on Capitol Hill. (Savage, 6/25)

A ruling against the Obama administration would have eliminated the subsidies in the 34 states that refused to set up an insurance exchange — including pivotal 2016 presidential battlegrounds such as Florida, Wisconsin and Ohio. The Urban Institute estimated that more than 8.2 million people would be uninsured as a result, which could have dramatically destabilized insurance markets. (Haberkorn and Gerstein, 6/25)

The Supreme Court rescued President Obama's health care law on Thursday for the second time in three years, rejecting a conservative challenge to the law's financial structure that could have proved fatal. ... The high court's action virtually guarantees that Obama will leave office in January 2017 with his signature domestic policy achievement in place. (Wolf and Heath, 6/25)

The Supreme Court handed President Obama a major victory Thursday, rejecting a conservative bid to undermine a key element of the Affordable Care Act and saying critics seized on an “implausible’’ argument. (Jan, 6/25)

In dissent on Thursday, Justice Antonin Scalia called the majority’s reasoning “quite absurd” and “interpretive jiggery-pokery.” He announced his dissent from the bench, a sign of bitter disagreement. His summary was laced with notes of incredulity and sarcasm, sometimes drawing amused murmurs in the courtroom as he described the “interpretive somersaults” he said the majority had performed to reach the decision. (Liptak, 6/25)

The Supreme Court on Thursday upheld a key part of the Affordable Care Act that provides health insurance subsidies to all qualifying Americans, awarding a major victory to President Obama and validating his most prized domestic achievement. ... Joining the chief justice in the majority were Justices Anthony M. Kennedy, Ruth Bader Ginsburg, Stephen G. Breyer, Sonia Sotomayor and Elena Kagan. Opposing the decision were Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr.(Barnes, 6/25)

The latest and possibly the last serious effort to cripple Obamacare through the courts has just failed. On Thursday, for the second time in three years, the Supreme Court rejected a major lawsuit against the Affordable Care Act -- thereby preserving the largest expansion in health coverage since the creation of Medicare and Medicaid half a century ago. (Cohn & Young, 6/25)

Democrats said it was finally time to accept that the Affordable Care Act was here to stay. Republicans vowed to keep trying to get rid of the law, but conceded that at this point, their best chance would be by winning back the White House next year. And people like Margaret McElwain, who has breast cancer and a part-time job at Target, exulted over the Supreme Court’s decision to allow health insurance subsidies to keep flowing to more than six million Americans in the 34 states that did not establish their own online insurance marketplaces under the law. (Goodnough and Tavernise, 6/25)

Thursday's Supreme Court decision, upholding the insurance subsidies for about 6.4 million consumers in 34 states, is a relief to more than those lower-income Americans. It also helps avert a crisis in the health care and insurance markets that would have sent ripples through the businesses that insure their own workers, experts say. ... There was also concern about the confusion a decision ending subsidies would have created among workers. For example, dependents who bought their own subsidized plans on the federal exchange because it was cheaper than being on a parent's plan, would likely have wanted to get on parents' plans, she said. (O'Donnell and Ungar, 6/25)

For months, 60-year-old Celia Maluf, of Miami, has been filled with dread over the Supreme Court's decision on the Obamacare subsidies. Had the Court sided with the plaintiffs in King v. Burwell, more than 6 million Americans in 34 states that rely on the federal marketplace would have lost their subsidies. (Andrews, 6/25)

Across the country, people who used the federal health insurance exchange to buy subsidized health insurance expressed relief about Thursday’s ruling in King v. Burwell. "I felt like I was out at the edge of a cliff," said Steve Creswell, 63, of Hixson, Tenn., who feared the loss of his subsidy would have increased his insurance premium from $27 a month to over $400. (Galewitz, 6/25)

Throughout the country, relief was the dominant emotion among consumers who get help from the government to lower their health insurance costs following Thursday's Supreme Court ruling upholding the subsidies underpinning President Barack Obama's health care overhaul. Many consumers expressed somewhat conflicting views: They were happy their monthly premiums would continue to be affordable but exasperated by the coverage the policies purchased on the new health care exchanges provide. (Johnson, 6/25)

More than 6 million Americans who stood to lose federal help in paying for health insurance got a break on Thursday when the Supreme Court upheld one of the most important provisions of Obamacare: the federal subsidies. The Court ruled 6-3 in favor of the subsidies, one of the main provisions of so-called Obamacare. That means people like Tony Teffeteller don't have to worry about paying for their health insurance. (Fox, 6/25)

Thursday's Supreme Court ruling validating federal health insurance subsidies for nearly 6.4 million Americans had consumers breathing a sigh of relief that they would be able to afford their policies, but the reaction was markedly different from governors and lawmakers in states that have fought against the Affordable Care Act. (Kennedy, 6/25)

Obamacare supporters everywhere are celebrating a win from the U.S. Supreme Court. With a 6-3 vote, the court decided Thursday that Americans who buy coverage through health care exchanges run by the federal government can continue to receive subsidies. ... Many in Massachusetts had a close personal or professional interest in this case. (Bebinger, 6/25)

California officials and consumer groups cheered the Supreme Court's ruling Thursday to uphold Obamacare premium subsidies nationwide, and some health-law supporters chided justices for hearing the challenge in the first place. (Terhune, 6/25)

In upholding the right to subsidies under the Affordable Care Act, the Supreme Court simply recognized that four misplaced words in a voluminous piece of landmark legislation did not tell the complete story of the measure’s intent. More than that, the ruling saves Texas — already with the highest percentage of uninsured residents in the nation — from suffering more from the hurtful coverage gap that the ACA seeks to close. (Pimentel, 6/25)

Texas officials expressed disappointment with the U.S. Supreme Court's decision to uphold the Affordable Care Act on Thursday, with Attorney General Ken Paxton calling it "unfortunate news" and Gov. Greg Abbott accusing America's highest court of abandoning the Constitution. "The Supreme Court abandoned the Constitution to resuscitate a failing healthcare law," Abbott said in a statement shortly after the 6-3 ruling came down from Washington. "Today's action underscores why it is now more important than ever to ensure we elect a President who will repeal Obamacare and enact real healthcare reforms." ... Democratic legislative leaders celebrated the ruling, which will allow more than 800,000 Texans residents to keep receiving an average of $250 worth of subsidies toward insurance. (Rosenthal, 6/25)

Tennesseans can continue to use tax credits to help them purchase insurance through the federally run health insurance exchange. Some health care advocates, politicians and hospital executives argue the U.S. Supreme Court ruling on King vs. Burwell that deemed those subsidies legal also opens the door for lawmakers to take another crack at passing Gov. Bill Haslam's controversial health insurance proposal, Insure Tennessee. (Boucher, 6/25)

One jubilant phone call after another came into the Connelly house in Amelia on Thursday morning with the news of the 6-3 U.S. Supreme Court decision on Obamacare. “Yay!” said Cindy Connelly. “I was on the phone with my friends, and we all have subsidies, and we just kept asking, ‘Did you hear? The subsidies passed!’ ” The high court’s ruling keeps in place the federal subsidies that help Cindy Connelly, her husband Mike and more than 160,000 other Ohioans pay for health insurance that they purchased through the healthcare.gov marketplace. (Saker, 6/25)

The U.S. Supreme Court, in a 6-3 ruling Thursday, upheld the Affordable Care Act subsidies that have helped millions of Americans, including 412,000 Georgians, obtain insurance coverage. The ruling was hailed as a huge victory for President Obama and for the ACA, although the constitutionality of the 2010 law was not in dispute in this case. (Miller, 6/25)

In a 6-3 decision, the Supreme Court upheld a high-profile challenge to the Affordable Care Act that could have made health insurance unaffordable for more than 5 million people. The case, King v. Burwell, addressed whether income-based tax subsidies should be available to consumers who purchased their insurance on the federal health-care exchange because their states did not set up their own exchange. The subsidies come from federal funds and are used to bring down the cost of insurance for people who cannot afford it. (Bouscaren and Mannies, 6/25)

The message was simple: “The Affordable Care Act is here to stay.” Those were the words of a triumphant President Barack Obama immediately after the U.S. Supreme Court’s ruling Thursday that upheld a major tenet of his health care overhaul. In a 6-3 ruling, the court said government subsidies to offset the cost of health insurance would continue to be available to consumers across the country. The decision means 200,000 Missourians and 230,000 Illinoisans will continue to get help with their health insurance bills. (Shapiro, 6/26)

More than 30,000 New Hampshire residents who got federal tax subsidies to purchase health insurance on the Obamacare website heaved a collective sigh of relief on Thursday, as the U.S. Supreme Court ruled that the subsidies are legal. The much-anticipated 6-3 ruling in King v. Burwell was hailed by supporters of the Affordable Care Act, who said the decision suggests the ACA is here to stay. (Solomon, 6/25)

Officials in Washington state, which has largely supported the Affordable Care Act, welcomed the news Thursday of the U.S. Supreme Court’s decision upholding a key provision of the health-care overhaul. Because this state has its own exchange, Washington Healthplanfinder, the more than 124,000 residents receiving premium-reducing subsidies through the exchange would have continued to get that benefit. On average, insurance with a subsidy costs $174 a month per person in Washington, while unsubsidized insurance sold through the exchange cost $384. (Stiffler, 6/25)

The Carolinas dodged a health care crisis Thursday when the U.S. Supreme Court preserved insurance subsidies for more than 6 million Americans, including almost 459,000 in North Carolina. But even as the Carolinians who get federal help buying private policies exhaled in relief, the battle over health reform raged anew. Republicans, who would have been under pressure to come up with a quick alternative if the court had overturned the subsidies, renewed their criticism of the Affordable Care Act. (Helms, 6/26)

Of the approximately 385,000 Virginians enrolled in health plans through the Affordable Care Act marketplace, 83 percent receive subsidies, according to federal data. The average monthly premium was $348 per person before tax credits averaging $259 reduced monthly premiums to $89, a 74 percent reduction. (Smith, 6/25)

For President Obama, the threats to his health-care law have spanned the 6 1/2 -year arc of his presidency and come from virtually every direction: the Congress, the courts and the administration itself in the form of an initially faulty Web site. ... But this was a cheerful moment to remember — an inflection point, as White House aides like to say, that brought an emerging domestic legacy into sharper focus. (Nakamura, 6/25)

For years, President Obama has faced the sneers of political adversaries who called his health care law Obamacare and assailed his effort to build a legacy that has been the aspiration of every Democratic president since Harry S. Truman. But on Thursday, Mr. Obama walked into the Rose Garden to accept vindication as the Supreme Court, for a second time, affirmed the legality of a part of the Affordable Care Act. Mr. Obama said the law “is working exactly as it’s supposed to” and called for an end to the vitriolic politics that have threatened it. (Shear, 6/25)

Republicans' chances of repealing the law, which provides health coverage to more than 20 million Americans, all but evaporated after the strongly worded decision written by Chief Justice John G. Roberts Jr. ... With no serious Republican alternatives and a historic expansion in medical coverage well underway, Obamacare is about as firmly ensconced as a new law can be in a politically divided country. (Levey, 6/25)

The Affordable Care Act is now “woven into the fabric of America,” Obama told reporters in a partially ad-libbed set of remarks from the White House Rose Garden, scoffing at the “misinformation,” “doomsday” predictions and “political noise” that have surrounded his law for five years. (Memoli and Parsons, 6/25)

President Obama and Chief Justice John G. Roberts Jr. got off to a rough start from the very beginning, when they tripped over each other’s words during a key line in the oath at Obama’s first inauguration. ... But in Thursday’s Supreme Court decision upholding federal subsidies offered under the Affordable Care Act, Roberts again helped sustain the president’s policy legacy in a way that few could have anticipated when Obama took office. In voting with the majority and writing the opinion, the chief justice has ensured that the legacies of both the Obama presidency and the Roberts court are forever intertwined. (Eilperin and Barnes, 6/25)

President Barack Obama struck a triumphant tone as he declared that his signature health care law "is here to stay" shortly after a Supreme Court ruling upholding nationwide subsidies under the Affordable Care Act. (Abdullah, 6/25)

The Supreme Court’s decision to uphold a key part of President Barack Obama’s health law did more than preserve subsidies for millions of Americans. For the second time in three years, it helped cement his legacy. (Galewitz, 6/25)

Chief Justice John Roberts’ decision, which was joined by the swing Justice Anthony Kennedy and the court’s four liberals, offered special vindication to Obama because it also affirmed that the whole point of his law was to improve the healthcare system. (Wheaton, 6/25)

Since becoming chief justice 10 years ago, John G. Roberts Jr. has been determined to show that the court he leads is made up of impartial jurists, not politicians in robes. In the phrase he used at his confirmation hearings, each justice is "like an umpire" at a baseball game — not favoring one team over the other. On Thursday, Roberts showed again his willingness to brush aside partisan politics and forge a middle ground on some of nation's most divisive issues, writing a 6-3 decision that upheld the broad reach of President Obama's healthcare law. (Savage,6/25)

On Thursday, for a second time, he wrote the ruling that preserved President Barack Obama’s signature legislative achievement. The ruling, however, made clear the chief justice is building another kind of legacy, one in which he is trying to keep the Supreme Court out of Congress’s way in important and potentially divisive policy areas. (Kendall, 6/25)

Conservatives were left baffled after Chief Justice John Roberts saved Obamacare three years ago. On Thursday, as the George W. Bush appointee again helped President Barack Obama’s signature legislative achievement avoid a potentially devastating blow, they felt betrayed. Adding to the sting: The chief justice wasn’t just along for the ride. When the court’s ruling allowing the law’s insurance subsidies to be offered nationwide emerged, he wrote the majority opinion and delivered it from the bench. (Gerstein, 6/25)

Supreme Court Justice Antonin Scalia’s laugh line in his health-care ruling dissent — “We should start calling this law SCOTUScare” – resonated on Capitol Hill. A number of House Republicans expressed frustration with Chief Justice John Roberts and his majority opinion upholding federal subsidies under the Affordable Care Act. It was the second time Chief Justice Roberts sided with the majority to keep key parts of President Barack Obama’s signature domestic initiative, leaving some conservatives questioning his conservative principles. (Stanley-Becker and Peterson, 6/25

The Supreme Court ruling Thursday is the second time Chief Justice John Roberts and Associate Justice Antonin Scalia have squared off on President Obama's health-care reform law. The chief justice wrote the decision upholding the law the first time it came before the court in 2012, and Scalia dissented. Roberts used the dissent's own words against Scalia in the case decided this week, which focused on what Congress was trying to do when it passed the Affordable Care Act, generally known as Obamacare. (Ehrenfreund, 6/25)

Supreme Court Justice Antonin Scalia and his conservative colleagues may have been overruled in Thursday's decision upholding ObamaCare subsidies, but they didn't go down without a fight. (6/25)

If blockbuster Supreme Court battles ended the way sports championships do, U.S. Solicitor General Donald Verrilli would be soaked in champagne and showered with Gatorade. And Jones Day partner Michael Carvin, the lawyer for the losing plaintiffs, would glumly file back into a hushed locker room. ... And once again, Mr. Verrilli prevailed, when Chief Justice Roberts united with the court’s liberal wing in refusing to dismantle the health law. (Gershman, 6/25)

The case was considered the greatest threat to the future of the law commonly known as Obamacare since three years ago, when the court rejected a separate challenge to the law's mandate that most Americans buy health insurance. Here's the decision, and below are answers to a few questions you might have about the big lawsuit. (Ehrenfreund, 6/25)

The Supreme Court justices could have chosen from among many esoteric legal arguments to uphold Obamacare subsidies. Instead, they relied on “Insurance 101.” (Kenen, 6/25)

For years, President Obama has faced the sneers of political adversaries who called his health care law Obamacare and assailed his effort to build a legacy that has been the aspiration of every Democratic president since Harry S. Truman. But on Thursday, Mr. Obama walked into the Rose Garden to accept vindication as the Supreme Court, for a second time, affirmed the legality of a part of the Affordable Care Act. Mr. Obama said the law “is working exactly as it’s supposed to” and called for an end to the vitriolic politics that have threatened it. (Shear, 6/25)

Moments after the Supreme Court upheld a key provision of the Affordable Care Act, aka Obamacare, our inbox began to be flooded with statements from politicians either condemning or praising the 6 to 3 ruling. These e-mails were then followed by queries from readers asking for an explanation of the facts spouted in those statements. Here’s a guide to some of the rhetoric, much of which we have covered in the past. As is our practice with such round-ups, we do not award Pinocchios. (Kessler, 6/26)

What, exactly, did Congress mean when it wrote those four nettlesome words? ... Interviews with several people involved in writing the legislation, from both sides of the aisle, conducted before the decision came down, offer some intriguing possibilities. (Bravin, 6/25)

The Supreme Court ruled that President Obama’s health care law may provide nationwide tax subsidies to help poor and middle-class people buy health insurance. The bottom line: Chief Justice John G. Roberts Jr. explained why he and five other justices turned back this challenge to the Affordable Care Act. (Savage, 6/25)

The Supreme Court Thursday upheld a key part of the 2010 health law – tax subsidies for people who buy health insurance on marketplaces run by the federal government. KHN’s Mary Agnes Carey discusses the decision with Stuart Taylor Jr., of the Brookings Institution, and KHN’s Julie Appleby. (6/25)

Obamacare has cleared a second major hurdle at the Supreme Court — but its troubles are far from over. The law is still highly unpopular, and significant structural issues remain: Health insurance rates are rising, many people don’t have as much choice of doctors and hospitals as they’d like, some states continue to struggle with their exchanges, and 21 states still haven’t backed Medicaid expansion. (Haberkorn and Pradhan, 6/25)

At least in Congress and the courts, probably not much. Despite expressing renewed resolve to repeal the health law, congressional Republicans know any such effort would face a certain veto from President Obama. And they are far from united on any particular plan. Meanwhile, legal challenges to the law remain, but none poses as serious a threat as King v. ­Burwell, which aimed at a pillar of the law — the insurance subsidies being provided to millions of people through the federal exchange. Most of the near-term action on the law, in fact, will occur in insurance companies, hospitals and government offices where people are working furiously to implement a complicated statute in a fast-changing environment. (DeBonis, Snell and Sun, 6/25)

In its first five years, the Affordable Care Act has survived technical meltdowns, a presidential election, two Supreme Court challenges — including one resolved Thursday — and dozens of repeal efforts in Congress. But its long-term future still isn’t ensured. Here are five of the biggest hurdles left for the law. (Appleby, Carey, Galewitz and Rau 6/26)

But Jonathan Adler, a professor at Case Western Reserve University School of Law, said there are still viable challenges, including a lawsuit filed by House Republicans that accuses the Obama administration of exceeding its powers in funding and enforcing the health-care law. “The House suit looks more plausible now than it did originally,” Mr. Adler said. “The appropriations issue seemed to bother the judge.” The Obama administration is also facing a lawsuit in Ohio alleging that it is levying an unconstitutional tax through the Affordable Care Act. While the lawsuit isn’t an existential threat to the health law, it could chip away at its foundation if successful. (Palazzolo, 6/25)

If you thought the legal fight over the health care overhaul was finally over, think again. At least four issues related to the Affordable Care Act still are being sorted out in the courts, although none seems to pose the same threat to the law as the challenge to nationwide subsidies that the court rejected on Thursday, or the constitutional case that the justices decided in favor of the law in 2012. (6/25)

The Supreme Court handed down a victory for the Affordable Care Act, ruling that people living in states with federal health exchanges are eligible for tax subsidies despite language in the law. Gwen Ifill looks at the ruling with Marcia Coyle of The National Law Journal, then gets reactions from Neera Tanden of the Center for American Progress and Michael Cannon of the Cato Institute. (6/25)

Bills to advance or cripple the law in statehouses didn't come to a halt in the months that lawmakers awaited the Supreme Court decision. They may well smolder for months or years. (Schulte, 6/25)

The health care act’s big win at the U.S. Supreme Court could mean the eventual end of MNsure. Republicans at the Legislature this year called for switching to healthcare.gov, the exchange operated by the federal government for 34 states, because of technical problems at MNsure and questions about its finances. (Snowbeck, 6/25)

When the U.S. Supreme Court ruled Thursday that nationwide subsidies under the federal Affordable Care Act are legal, supporters of the law in Minnesota celebrated the decision. (Zdechlik, 6/25)

Despite having survived a challenge in the U.S. Supreme Court, the federal government’s health insurance markets face weighty struggles as they try to keep prices under control, entice more consumers and encourage quality medical care. The government’s insurance markets – as well as more than a dozen run by states — have been operating for less than two years and are about to lose their training wheels. Start-up funds that have helped stabilize prices and partially pay for administration of the marketplaces are ending, feeding fears that premiums may rise after next year at a steeper rate. (Rau, 6/25)

The Supreme Court rebuffed the latest (and likely last) judicial challenge to Obamacare on Thursday, ruling in a 6-3 decision that the law entitles Americans in all 50 states to health insurance subsidies. Opponents of Obamacare were hoping that the Court would undermine one of the law's central components by ruling that insurance tax credits were available only to consumers in the 14 states that set up their own insurance marketplaces - not those in the 36 states that used the federal marketplace. (Miller, 6/26)

The Supreme Court’s decision to uphold Obamacare subsidies nationwide sidesteps a crisis at the state level and puts the focus back on the stalled push to get more states to expand Medicaid. (Pradhan, 6/25)

U.S. Health and Human Services Secretary Sylvia Burwell said on Thursday the Obama administration will focus on improving quality over quantity in the nation's healthcare system in the implementation of the Affordable Care Act. The Supreme Court ruled earlier on Thursday to uphold the nationwide availability of tax subsidies that are crucial to President Barack Obama's signature healthcare law, also known as Obamacare. In a conference call with reporters, Burwell said the administration planned to push further on a patient-centered approach. (Dunsmuir, 6/25)

Groups representing health systems, physicians, health insurers and community health centers in Wisconsin applauded the U.S. Supreme Court's decision that preserved the federal subsidies available to buy health insurance under the Affordable Care Act. (Boulton, 6/25)

With the U.S. Supreme Court backing the Affordable Care Act for the second time in three years, Arizona hospitals and health interests say it removes major uncertainty about the health-care law that has extended coverage to more than a half-million Arizonans. (Alltucker, 6/25)

The man in charge of the Cook County Health & Hospitals System greeted the U.S. Supreme Court’s decision to back federal subsidies for Obamacare with a sense of relief Thursday. Had the nation’s highest court killed those subsidies, it could have meant a huge increase in Cook County patients unable to pay their medical bills, said the system’s CEO, Dr. John Jay Shannon. (Esposito, 6/25)

After much anticipation and uncertainty, the Supreme Court made its decision on Thursday morning and upheld subsidies for people who get their health insurance through the federal marketplace. Obamacare ruling brings relief to Florida Obamacare ruling brings relief to Florida That means more than 100,000 Central Floridians will be able to keep their Obamacare health insurance, because their subsidies aren't going away. (Miller, 6/25)

The U.S. hospital and health insurance industries breathed a collective sigh of relief on Thursday after the U.S. Supreme Court upheld subsidies for individuals under President Barack Obama's signature healthcare law. Shares in hospitals surged, with several hitting all-time highs, on the expectation that patients would be able to continue paying for services. Health insurer stocks also gained. Wall Street analysts called the ruling positive for an industry on the edge of consolidation. (Humer and Berkrot, 6/25)

Health insurers and hospital operators were relieved by Thursday’s Supreme Court ruling, which upholds subsidies for millions of customers in an industry already bracing for belt-tightening and a new round of consolidation. (Wilde Mathews and Weaver, 6/25)

The U.S. Supreme Court has ruled 6-3 to uphold tax subsidies that are at the core of President Barack Obama’s Affordable Care Act law. Bloomberg’s Shannon Pettypiece and Julie Hyman examine what the ruling means to hospital and health care companies. (6/25)

In wake of the decision, employers and other healthcare industry officials urged political leaders to tackle the unfinished business of taming the country's runaway medical spending. ... On Wall Street, hospital and health insurance company stocks rallied on news of the court decision. (Terhune, 6/25)

Hospitals led a rally among health-care companies as the U.S. Supreme Court upheld a key piece of President Barack Obama’s Affordable Care Act, lifting the main threat hanging over the industry’s prospects. HCA Holdings Inc., Tenet Healthcare Corp. and Community Health Systems Inc. all gained more than 8 percent after the ruling. Health insurers also advanced. (Tracer, 6/25)

Thursday's 6-3 Supreme Court vote upholding a major tenet of the Affordable Care Act means health insurers and health care providers are breathing a sigh of relief — this is the outcome they wanted — but that doesn’t mean they can rest. They're still in the process of figuring out how to thrive in this still-new health care environment. (Gorenstein, 6/25)

President Obama wasn't the only one cheering Thursday's Supreme Court ruling in favor of Obamacare. Investors were too. Health care stocks surged on the news. Hospitals were the biggest winners. Tenet Healthcare (THC) jumped over 12%, making it the top gaining stock of the day. The company runs 80 hospitals in the U.S. and over 400 outpatient facilities. (Long, 6/25)

On Thursday morning, stock prices of hospitals and five of the biggest health insurers climbed after the Supreme Court handed a victory to Obamacare. The 6-3 decision in King v. Burwell upheld a key part of the 2010 Affordable Care Act, which offered tax subsidies to states to establish their own health care exchanges. Major hospitals led the surge. Dallas-based health service provider Tenet Healthcare soared nearly 12 percent after the ruling. Community Health Services, the biggest non-rural hospital chain, climbed nearly 10 percent. HCA Holdings, the parent company of Hospital Corporation of America, rose close to 9 percent. LifePoint Hospitals, which provides health services in rural areas, swelled about 7 percent. (Kaufman, 6/25)

Stocks of hospital operators and other providers of health care rallied Thursday after the U.S. Supreme Court voted 6-3 in upholding tax subsidies that are central to President Barack Obama's Affordable Care Act. HCA Holdings (HCA) and Tenet Healthcare (THC) both jumped nearly 9 percent in the moments after the high court ruling. By the close of the session, shares of HCA were up about 9 percent and Tenet Healthcare were up 12 percent. (Gibson, 6/25)

Republicans took to Twitter, e-mail, and other electronic media minutes after the Supreme Court announced its ruling to uphold President Obama’s landmark health care law. The common theme: outrage, especially among 2016 presidential contenders. ... But observers said the Supreme Court ruling was actually a win in disguise for the GOP. It allows Republicans to avoid the massive political backlash expected if the court sided with conservative plaintiffs and left more than 6 million people in 34 states without subsidies to buy health insurance. (Linskey, 6/25)

Republican presidential hopefuls signaled Thursday they have no plans to abandon their quest to repeal Obamacare after the Supreme Court ruled in favor of the law for the second time since its passage in 2010. (Rafferty, 6/25)

Infuriated by a U.S. Supreme Court ruling that kept President Barack Obama’s healthcare program intact, conservative activists and Republican presidential candidates vowed on Thursday to make the role of the high court a central issue in the 2016 presidential election. Conservative ire was trained particularly on Chief Justice John Roberts, who wrote the majority opinion that preserved the subsidy regime underpinning the Affordable Care Act, even though another Republican appointee, Justice Anthony Kennedy, also voted with the majority. (Oliphant, 6/26)

The Supreme Court's resounding rejection of a conservative attempt to gut President Barack Obama's health care overhaul won't stop Republicans from attacking the law they detest. But now, their efforts will be chiefly about teeing up the issue for the 2016 presidential and congressional elections. The court's decision left GOP lawmakers stunned and uncertain about some of their next steps. Most agreed they would continue trying to annul the entire law and erase individual pieces of it, like its taxes on medical devices. Yet many also conceded they have little leverage to force Obama to scale back — let alone kill — one of his most treasured legislative achievements. (6/26)

NPR's Rachel Martin speaks with Rep. Tom Price, who has led efforts to undo the Affordable Care Act. Price, a doctor, has introduced alternatives that he says would cover more people. (6/25)

Republican presidential hopeful Marco Rubio criticized the high court ruling on "Obamacare" subsidies, saying the Affordable Care Act is bad for Americans and bad for the country. "You have a lot of people out there today who are receiving Obamacare coverage through a subsidized exchange who, when they get to the hospital, are being hit with a $4,000 bill because they have a high deductible," Rubio said while campaigning in New Hampshire. (Touhy, 6/25)

Louisiana Gov. Bobby Jindal, in his first interview in New Hampshire as a presidential hopeful, said he is the only candidate with a plan to replace "Obamacare." The Republican blasted the U.S. Supreme Court decision on the Affordable Care Act and its subsidies. He said the ruling underscores the importance of the 2016 election. (Tuohy, 6/25)

Sen. Ted Cruz delivered a full-throated critique Thursday of the Supreme Court, saying that it is clear that the “rogue justices” that ruled in favor of Obamacare subsidies are “lawless” political foot soldiers that have joined forces with the Obama administration. (McLaughlin, 6/25)

Even as Republicans rose in a chorus of outrage Thursday over the Supreme Court’s refusal to gut the Affordable Care Act, party leaders were privately relieved. Republicans were spared the challenge of having to come up with a solution for the 6.4 million Americans — most of them in conservative states — who might have found their health insurance unaffordable had the court gone the other way. (Tumulty, 6/25)

Democrats celebrated. Republicans fumed. And while some promised to continue fighting to kill President Obama's signature health law after Thursday's defeat at the Supreme Court, others in the GOP said it was time to try other tactics, at least until they can take back the White House. (Tamari, 6/26)

Republicans have tried to kill the health care law twice at the Supreme Court, only to be rebuffed. They’ve held more than 50 repeal votes, virtually all of which have died in the Senate. They tried to defund the law through the spending process, but the government shut down instead. (Raju and Everett, 6/25)

Republicans stuck by their anti-Obamacare rhetoric Thursday after the Supreme Court upheld Obamacare subsidies — but the party was divided on whether to use a fast-track budget procedure to kill the law they love to hate. Shortly after the court handed down its 6-3 ruling in King v. Burwell, finding that subsidies awarded through federal-run health care exchanges were constitutional, Speaker John Boehner (R-Ohio) said Republicans were still weighing their next legislative steps — and, notably, did not commit to using the expedited procedure, called reconciliation, to repeal the entire thing. (Bade, 6/25)

Ohio Republicans said Thursday they would keep trying to unravel the Affordable Care Act, even though the Supreme Court rejected their latest legal attack on the health care law. "The law is broken," said House Speaker John Boehner, R-West Chester. "We're going to continue our efforts to put the American people back in charge of their own health care." (Shesgreen, 6/25)

U.S. Rep. David Jolly used Thursday's Supreme Court ruling on the Affordable Care Act to remind folks he introduced a bill last year to repeal the law individual insurance mandate -- and to proclaim that he will continue to push that legislation that died in committee last year. "I believe the American people should be in control of their own health care coverage decisions, not government," Jolly said in a post on his Facebook page. "Which is why, despite today’s U.S. Supreme Court ruling, I am continuing to push legislation (H.R. 143) restoring the freedom of all Americans to decide what health care coverage is right for them and their family." (Marrero, 6/25)

President Barack Obama has had a good week. First, Congress salvaged his trade agenda, setting the stage for passage of a sweeping free-trade agreement. Then, on Thursday, the U.S. Supreme Court kept his health-care law intact, preserving his signature domestic achievement. (Murray, 6/25)

The Senate Appropriations Committee on Thursday advanced a nearly $153.2 billion bill that chips away at ObamaCare, just after the Supreme Court upheld a critical portion of the healthcare law. It marks the first time the full committee reported the measure in two years. The legislation would fund the departments of Health and Human Services (HHS), Labor, and Education in the next fiscal year, which begins Oct. 1. Those departments would receive $3.6 billion less than Congress enacted for this year and a whopping $14.5 billion less than President Obama’s request. (Shabad, 6/25)

The top Democratic House appropriator for federal health programs is seeking to stop a federal task force from issuing a new set of breast cancer screening recommendations that she says would make mammography more expensive and thus inaccessible for some women in their 40s. Rosa DeLauro of Connecticut on Wednesday thanked House Labor-Health and Human Services-Education Appropriations Chairman Tom Cole, R-Okla., for a new provision in his spending bill that's intended to block the planned new recommendations from the United States Preventive Services Task Force for a year. The provision was added to the manager's amendment, which was adopted by voice vote, to the fiscal 2016 spending bill at a Wednesday markup. DeLauro said she is concerned that a new set of recommendations from the task force could lead insurers to require women in their 40s to pay part of the cost of mammograms. (Young, 6/25)

Two moderate GOP appropriators led an effort Thursday to block a fellow Republican’s plan to shave Title X family planning funds by about 10 percent, a marked contrast to their House counterparts who want to terminate the program. The amendment was among the most noteworthy proposals during a markup Thursday in the Senate Appropriations Committee. The Senate committee voted 16-14 to report the fiscal 2106 Labor-Health and Human Services-Education bill, which would cut overall spending from the 2015 enacted level by almost $4 billion to $153 billion and is $14.5 billion below President Barack Obama's request. The House bill is nearly equal in its cut and would provide about the same amount. (Young, 6/25)

Let the deal music play. In affirming a central tenet of the Affordable Care Act for the second time, the U.S. Supreme Court has removed a major source of uncertainty for the insurance industry. That is good news for investors banking on consolidation. Indeed, within hours of the decision, Humana stock popped on renewed talk that Aetna had made an offer, as reported this weekend by The Wall Street Journal. (Grant, 6/25)

Aetna Inc., the second-largest U.S. health insurer by market value, is closing in on an acquisition of Humana Inc. and could reach a deal as early as this weekend, several people with knowledge of the matter said. Discussions between the two companies have intensified during recent days, after it emerged over the weekend that rivals Anthem Inc. and Cigna Corp. had held merger talks of their own, said the people, who asked not to be identified discussing private information. (Hammond, Campbell and Tracer, 6/25)

A new round of consolidation in the health insurance industry appeared closer as companies seek to grow larger, driven in part by cost-cutting and opportunities that are part of the Affordable Care Act. In the latest jockeying, Humana, the smallest of the big five insurers, is pursuing a deal to sell itself and could reach an agreement by next week, according to a person briefed on the matter, who spoke on the condition of anonymity. Among those in the running to buy it are two bigger competitors, Aetna and Cigna. (de la Merced, 6/25)

After months of rancorous debate and emotional pleas from parents, a bill that would force most Californians to vaccinate their children cleared its last major legislative hurdle on Thursday. (Seipel and Calefati, 6/25)

California lawmakers on Thursday approved one of the toughest mandatory vaccination requirements in the nation, moving to end exemptions from state immunization laws based on religious or other personal beliefs. The measure, among the most controversial taken up by the Legislature this year, would require more children who enter day care and school to be vaccinated against diseases including measles and whooping cough. (McGreevy and Lin, 6/25)

California physician groups praised the Assembly’s passage of one of the toughest mandatory vaccination laws in the nation, and urged Gov. Jerry Brown to sign it if the bill reaches his desk. “To make a decision not to vaccinate is actually to make a decision to potentially harm the community,” said Dr. Jay W. Lee, president of the California Academy of Family Physicians. “The health of the public is going to be protected by this measure.” (Lin, 6/25)

The controversial bill that would require almost all children entering day care or school in California to be vaccinated crossed another key hurdle Thursday, as the state Assembly approved it by a vote of 46-30. The bill, SB 277, now returns to the state Senate, where lawmakers will be asked to concur with amendments made in the Assembly. (Plevin, 6/25)

Every year, Lawrence + Memorial Hospital CEO Bruce Cummings does what he calls a “back of the envelope” calculation. Should the New London hospital remain independent, with a series of partnerships with the Yale New Haven Health System in clinical fields such as radiation oncology, neonatology and angioplasty? Or would it make more sense to join the Yale New Haven system as an outright member? (Levin Becker, 6/26)

In the debate about whether Cooper University Hospital should take over ambulance services in Camden, a spokesman for hospital board chairman George E. Norcross III has implied that seriously injured patients would be best served by paramedics from a Level 1 trauma center such as Cooper. "If you were seriously injured, would you want your first care to come from the region's only Level 1 trauma center or a community hospital?" spokesman Dan Fee told the Inquirer on Wednesday. Yet the vast majority of patients picked up by ambulance are not trauma or injury victims, but patients suffering from heart problems, strokes and other acute illness. (Avril, 6/25)

A judge on Thursday blocked Kansas’ first-in-the-nation ban on an abortion procedure that opponents describe as dismembering a fetus, concluding that the law would likely present too big of an obstacle for women seeking to end their pregnancies. Shawnee County District Court Judge Larry Hendricks sided with New York-based Center for Reproductive Rights, agreeing to put the law on hold while he considers a lawsuit filed on behalf of two Kansas abortion providers. (Hanna, 6/25)

Rising temperatures and the start of summer vacations are driving down blood donations, resulting in critical shortages, officials with Bloodworks Northwest said Thursday. The agency, which supplies blood to 90 regional hospitals, issued an urgent appeal for donors after collections dropped about 20 percent — from 900 donations a day in the Puget Sound area to about 720 donations. (Aleccia, 6/26)

[The federal] Value-Based Purchasing program ... ties financial incentives to hospital performance on a range of quality measures. However, it remains unclear whether patient satisfaction is an accurate marker of high-quality surgical care. ... [The researchers studied 180 hospitals and grouped them] by quartile based on their performance on the Hospital Consumer Assessment of Healthcare Providers and Systems survey. ... those at the highest quartile had significantly lower risk-adjusted odds of death, ... failure to rescue ... and minor complication .... we demonstrated a significant association between patient satisfaction scores and several objective measures of surgical quality. Our findings suggest that payment policies that incentivize better patient experience do not require hospitals to sacrifice performance on other quality measures. (Sacks et al., 6/24)

Whether pediatric trauma centers (PTCs), mixed trauma centers (MTCs), or adult trauma centers (ATCs) offer a survival benefit compared with one another when treating injured children is controversial. ... [In a retrospective cohort study, the researchers] identified 175,585 injured children. ... After adjustment, children had higher odds of dying when treated at ATCs ... and MTCs ... compared with those treated at PTCs. In stratified analyses, young children had higher odds of death when treated at ATCs vs PTCs, but there was no association between center type and mortality among older children ... and adolescents .... [The study recommends that] quality improvement initiatives geared toward ATCs and MTCs are required to provide optimal care to injured children. (Sathya et al., 6/24)

This Visualizing Health Policy infographic provides a snapshot of men’s health care and insurance coverage issues, including health status, access to care, and use of services. It compares the uninsured rates of men and women; their cost barriers to care; their connection to clinicians; and their use of prescription drugs, screening, and counseling services. Fewer men than women gained coverage between October 2013 and March 2015, and the uninsured rate continues to be higher for men than women. Although men are less likely than women to experience cost barriers to care, uninsured men are twice as likely as all men to report cost barriers resulting in delayed care or reduced prescription medication use. Men are also are less likely to have seen a health care provider in the past 2 years and to seek screening services or discuss their sexual health with providers. (Kurani et al., 6/23)

In 2009, before passage of the 2010 Patient Protection and Affordable Care Act (ACA), approximately 20% of women aged 18–64 years had no health insurance coverage. In addition, many women experienced transitions in coverage around the time of pregnancy. Having no health insurance coverage or experiencing gaps or shifts in coverage can be a barrier to receiving preventive health services and treatment for health problems that could affect pregnancy and newborn health. With the passage of ACA, women who were previously uninsured or had insurance that provided inadequate coverage might have better access to health services and better coverage .... data from 2009 can be used as a baseline to measure the incremental impact of ACA on the continuity of health care coverage for women around the time of pregnancy. (D'Angelo et al., 6/19)

As millions of Americans gain Medicaid coverage under the Affordable Care Act, attention has focused on the access to care, quality of care, and financial protection that coverage provides. This analysis uses the Commonwealth Fund Biennial Health Insurance Survey, 2014, to explore these questions .... The survey findings suggest that Medicaid coverage provides access to care that in most aspects is comparable to private. Adults with Medicaid coverage reported better care experiences on most measures than those who had been uninsured during the year. Medicaid beneficiaries also seem better protected from the cost of illness than do uninsured adults, as well as those with private coverage. (Blumenthal, Rasmussen, Collins and Doty, 6/24)

The Affordable Care Act (ACA) mandated that many chain restaurants and other "similar" food establishments list the calorie count of the food they sell. The requirement will take effect nationwide in December 2015 .... The law might seem relatively straightforward, but a close reading of the final rule makes clear that virtually every word in section 4205 of the ACA--the statutory basis for the FDA rule--was ... subject to vigorous debate. ... Cost was also a hotly debated factor. The supermarket industry had said it might have to spend up to a billion dollars to implement the new labeling requirements; the restaurant industry said that number was a gross exaggeration. ... A larger, existential question is whether calorie and other nutrition labeling actually makes a difference in how many calories people consume. ... One of the major unresolved issues involving the new rules is determining who will enforce them. (Goldman, 6/25)

This report, based on the 2014 Kaiser Survey of Low-Income Americans and the ACA, aims to understand the impact that gaining coverage has had on the lives of the “newly insured” adult population. ... Most newly insured adults are in working families, many with a part-time worker. Despite concerns about adverse selection into coverage, about half of newly insured adults are under age 35 (similar to those who remained uninsured) .... While some newly insured adults changed where they regularly go for care and most see private doctor’s offices for their regular care, many continue to seek services from community clinics and health centers, which ... may be the most available source of care in their area. Still, survey findings show that newly insured adults face some access barriers compared to adults who were insured before 2014. (Garfield and Young, 6/19)

For many years, community-based programs have offered opioid overdose prevention services to laypersons who might witness an overdose, including persons who use drugs, their families and friends, and service providers. Since 1996, an increasing number of programs provide laypersons with training and kits containing the opioid antagonist naloxone hydrochloride (naloxone) to reverse the potentially fatal respiratory depression caused by heroin and other opioids. ... From 1996 through June 2014, surveyed organizations provided naloxone kits to 152,283 laypersons and received reports of 26,463 overdose reversals. (Wheeler et al., 6/19)

Nearly nine in 10 women with early breast cancer have imaging exams to see if the cancer has spread, despite official recommendations against such tests, a new study suggests. The American Society of Clinical Oncology and the National Comprehensive Cancer Network recommend against looking for metastatic cancer in women with stage I or II breast cancer. That’s because less than two percent of these women will have metastases, and there’s a high risk that the tests will be falsely positive, leading to unnecessary extra testing, delays and anxiety. (Doyle, 6/22)

The long-term success of an early autism treatment codeveloped by a University of California-Davis researcher was validated recently by a national study soon to be published in the Journal of the American Academy of Child & Adolescent Psychiatry. The Early Start Denver Model is a nonmedical treatment for children age 12-48 months who show symptoms of autism, a developmental disorder that can affect social skills, movement, attention span and intellectual ability. While autism is usually diagnosed in children between the ages of 2 and 3, a growing body of research suggests that diagnosing it early and intervening with one-on-one, parent-led treatment can reduce symptoms in the long run. (Caiola, 6/21)

Medical marijuana has not been proven to work for many illnesses that state laws have approved it for, according to the first comprehensive analysis of research on its potential benefits. The strongest evidence is for chronic pain and for muscle stiffness in multiple sclerosis, according to the review, which evaluated 79 studies involving more than 6,000 patients. Evidence was weak for many other conditions, including anxiety, sleep disorders, and Tourette's syndrome and the authors recommend more research. (Tanner, 6/23)

The popularity of electronic cigarettes and hookahs has overtaken traditional cigarettes among youths, according to a new study from the federal government. The Food and Drug Administration, and Centers for Disease Control and Prevention found e-cigarettes are the most popular tobacco product among middle and high school students. (Devaney, 6/23)

There may be 35 million older Americans with undiagnosed lung disease due to cigarette smoking, a new study suggests. They don't meet the criteria for a diagnosis of chronic obstructive pulmonary disease, but they still suffer significant lung disease and impairment, the researchers report in JAMA Internal Medicine. (Seaman, 6/22)

Efforts by community groups, schools, parents and government agencies to reduce underage drinking appear to be paying off, both nationally and here in Minnesota. Significantly fewer teens — especially at the lower ages — are using alcohol than did so a decade ago, according to a report released earlier this month by the Substance Abuse and Mental Health Services Administration (SAMHSA). Experts stress, however, that the decline needs to be viewed with caution. (Perry, 6/22)

A form of "virtual reality" therapy might help treat alcohol addiction, suggests a preliminary study from South Korea. The study involved only 10 patients with alcohol dependence. But senior researcher Dr. Doug Hyun Han of Chung-Ang University Hospital in Seoul and colleagues think the approach might be promising, in part because it puts patients in situations similar to real life and requires their active participation. (Doyle, 6/24)

The Supreme Court sided with common sense over ideology Thursday when it ruled that Congress intended all low-income Americans to be eligible for subsidized health insurance under the 2010 Patient Protection and Affordable Care Act. And contrary to what opponents of the healthcare law argued, the justices did not reach that decision by ignoring the plain meaning of the law or by allowing the Obama administration to usurp the power of Congress. In fact, the opposite was true: The court turned away a bogus and historically inaccurate reading that would have contradicted the law's very purpose. (6/25)

For a law that has been under ceaseless attack since Congress began debating it in 2009, Obamacare has proved to be remarkably durable — or lucky that its enemies have so far been inept. On Thursday, the Supreme Court dispensed with the latest legal challenge to the health law on a 6-3 decision, practically a landslide in a court that often divides 5-4 on major decisions. Opponents of the law had pinned their hopes for repealing or remaking Obamacare on this case; now they most likely have to live with the law unless a Republican president and Congress can find a way to dismantle it after the 2016 elections. That gets harder every year. (6/25)

The Supreme Court's decision in King v. Burwell on Thursday did not simply hold that the phrase "established by the state" means "established by anyone." Rather, it signaled that the text of the 900-page law is now subordinate to what the court sees as its unimpeachable purpose: "to improve health insurance markets, not to destroy them," regardless of the costs. If at all possible, "we must interpret the Act in a way that is consistent with the former, and avoids the latter," the chief justice wrote. Alas, with that goal in mind, it is always "possible" to save Obamacare from itself. (Josh Blackman, 6/25)

The Supreme Court’s ruling Thursday in King v. Burwell has temporarily saved the Affordable Care Act, but millions of Americans are still hurting under ObamaCare. The high court’s six-justice majority agreed that the IRS can change the wording of the law to the administration’s liking. No one, however, can change that ObamaCare is an expensive failure—unpopular, unworkable and unaffordable. (Sen. John Barrasso, R-Wyo., 6/25)

On Thursday morning, for the second time in three years, a majority of the Supreme Court rightly rejected a blatantly political effort to destroy the Affordable Care Act. The case challenging the law, King v. Burwell, was always an ideological farce dressed in a specious legal argument, and the court should never have taken review of it to begin with. (6/25)

For all the fuss, this really was a nothing of a court case. Last time the justices had to think deeply about complex concepts. What does liberty demand? How far should the federal government’s power reach? How do we balance individual choice and community responsibility? What does the Constitution say about all that, and what’s the correct way of understanding the Constitution? This time … none of that. As a judicial matter, this was simply about reading a complex law and figuring out what it meant. It is something lawyers are good at. (Jonathan Bernstein, 6/25)

[T]he big distractions — the teething problems of the website, the objectively ludicrous but nonetheless menacing attempts at legal sabotage — are behind us, and we can focus on the reality of health reform. The Affordable Care Act is now in its second year of full operation; how’s it doing? The answer is, better than even many supporters realize. (Paul Krugman, 6/25)

Obamacare survived another brush with death before the Supreme Court today. The justices permitted the government to continue to give subsidies to those who purchase coverage on the federally run insurance exchange. Had the Court ruled the other way, the law would not actually have been struck down. However, its effectiveness would have been severely limited. In the 34 states that use the federal exchange, healthcare.gov, most people with low incomes would have found it difficult or impossible to afford health insurance. They are the people most in need of law’s help. (Robert I. Field, 6/25)

Now that the Supreme Court has for the second time declined to dismantle the Patient Protection and Affordable Care Act, better known as Obamacare, one might begin to get the impression that it is the law of the land -- not only because it was duly passed by Congress and signed by the eponymous president, but also by virtue of being a reasonable response to one of the country's most pressing domestic policy problems. Of course, the landmark health-care reform has been all those things for more than five years. The greatest gift of Chief Justice John Roberts' latest opinion upholding the law is that the nation can at long last regard it as such. (6/26)

To read the majority decision of Chief Justice Roberts, the case was simply a matter of statutory construction. In reality, the issues were far broader, and involve the separation of powers and the most fundamental principles of American government. In the unseemly rush to pass Obamacare in 2010, Congress messed up. The draftsmanship was "inartful," Roberts tells us. At an earlier time, the Court would have interpreted the statute literally, struck it down, and sent it back to Congress to fix. The problem is, in an era of gridlock and an imperious presidency, that wasn't going to happen. (F.H. Buckley, 6/25)

Yesterday, the Supreme Court sided with the Obama administration in the King v. Burwell Obamacare case. In a statement after the decision, President Obama declared that his signature health law is “here to stay.” But in his remarks, the President knowingly ignored the key concept in the case: that if the challengers had won, not one word of the law called the “Affordable Care Act” would have been changed. On the other hand, if voters elect a Republican President and a Republican Congress in 2016, quite a bit will change. (Avik Roy, 6/26)

It was a smackdown. There’s really no other way to describe the ruling that the U.S. Supreme Court handed down on Thursday, rejecting the latest and maybe the last serious threat to the Affordable Care Act. (Jonathan Cohn, 6/25)

The court’s decision is also likely to send a message to the lower courts that it is time to bring the curtain down on ACA litigation. Dozens of cases have been filed over the half-decade that the ACA has been in force, challenging the constitutionality of the ACA itself as well as the way in which it has been implemented. Few of these cases have succeeded .... Given the Court’s admonition in King v. Burwell that courts should interpret the ACA to promote Congress’ intention to improve insurance markets and not destroy them, litigation against the ACA is likely to fare no better in the future. (Timothy Jost, 6/25)

Thursday's Supreme Court decision to uphold a pivotal regulation under the Affordable Care Act is, of course, a tremendous victory for the Barack Obama administration. But it also establishes a principle that's likely to haunt future presidents. (Disclosure: As administrator of the Office of Information and Regulatory Affairs from 2009 to 2012, I worked on, and helped oversee, the regulation at issue in the case.) The underlying question is which branch of government has the power to interpret ambiguous legislation. ... Roberts today ... upheld the Internal Revenue Service regulation allowing subsidies for qualified people buying health insurance on the federal exchange, but did so without giving any deference to the IRS. He declared unambiguously that it is "our task," and not that of the executive branch, "to determine the correct reading." (Cass R. Sunstein, 6/25)

The U.S. Supreme Court rescued Obamacare from a conservative attack for the second time in three years on Thursday, prompting Justice Antonin Scalia to rename the law "ScotusCare." He was just being puckish, as he often is in dissent, but he has a point: It's time for opponents of the law to take responsibility for it -- and that means working to improve it. ... Rather than continue to search for ways to convince voters or the courts that Obamacare is fundamentally flawed or structurally deficient, members of Congress need to cooperate and address the law's shortcomings -- which are real but surmountable. (6/25)

Far from putting this debate behind us, the ruling has freed Washington to take it up. Now that the long months of waiting silently and expectantly for the court’s decision are over, debate on ObamaCare is about to explode in a way not witnessed since 2010. The reason rests in another of Mr. Obama’s statements Thursday: “there can be no doubt this law is working.” Apply those Roberts Rules of Plain Textual Interpretation, and we find that what the president means is that families are still losing their doctors, still getting hit with double-digit premium hikes. What he means is that the law remains as unpopular as ever. (Kimberley A. Strassel, 6/25)

The Affordable Care Act (ACA) survived another review at the Supreme Court on Thursday. But Obamacare isn’t out of the woods yet. There will be a new president in January 2017, and if that president has a tall “R” next to his or her name, the pressure to undermine the ACA will be high. Republicans wouldn’t have any great options. But here are several things they might try, in order of least to most likely to happen. (Stephen Stromberg, 6/25)

Who are the winners from this decision? First, they include the Supreme Court itself. With the occasional exception, the court is traditionally wary of being seen as political agent. ... Republican officeholders are condemning the court decision virtually unanimously, but they're big winners too. The crisis an anti-ACA decision would have created for Americans dependent on insurance subsidies would fall hardest on states whose GOP leaderships have refused to set up state exchanges. (Michael Hiltzik, 6/25)

Had the court ruled the other way, millions would have been lost their health insurance policies. The fact that the GOP harped on repealing the law without offering or rallying around an alternative would have magnified the expected chaos in the health-care market and in the lives of millions of Americans. Despite their fist-shaking at the ruling, Republican Party leaders are breathing a sigh of relief. (Jonathan Capehart, 6/25)

The practical effect of the Supreme Court’s 6-3 ruling in King v. Burwell is clear: It allows federal subsidies to continue to be provided to more than 6 million people and calms the political waters surrounding the Affordable Care Act, allowing implementation to continue in a more certain and predictable environment for the health-care industry, states, and consumers. The ACA will, however, continue to be an issue in the run-up to the 2016 elections. Republicans in particular are likely to use the issue to rev up their base in hopes of increasing turnout in an election many think will hinge more on turnout than on efforts to move the increasingly small number of true independents. (Drew Altman, 6/25)

The Roberts Court has ruled twice that the Affordable Care Act is constitutional. So that debate is pretty much over. The law isn’t going to be thrown out by the judicial branch. The legislative branch better get to work if it wants to see it removed. You can’t beat something with nothing. If Republicans want to repeal Obamacare, they need to replace it with something that works better, that is easier to understand, and that will lead to better prices and higher quality for consumers. (John Feehery, 6/25)

Philip Klein is one of the right's smartest health-care writers, and in the aftermath of King v. Burwell, he has some advice for Republicans: they need "to lay out a detailed vision for market-based system, and to spend the next election doggedly making their case." This is not going to happen. Republicans are never going to unite around a serious replacement for Obamacare and endure the political pain necessary to get it passed. How do I know? Well, I read Overcoming Obamacare, Klein's excellent book on Republicans and health-care reform. And as Klein writes there, Republicans don't care that much about health reform. (Ezra Klein, 6/26)

For the second June in four years, the Supreme Court, led by its conservative chief justice, John G. Roberts Jr., has affirmed the legal framework of the Affordable Care Act of 2010 — the signature achievement of the Obama-era Democratic Party and a national social policy landmark. In so doing, the Roberts court assured the permanent expansion of social protections in America, and also saved the Republican Party from a no-win explosion its own extreme right-wingers tried to ignite. (Theda Skocpol andn Lawrence R. Jacobs, 6/25)

Thhe Supreme Court today upheld a key provision in the Affordable Care Act, ruling 6 to 3 in King v. Burwell to maintain federal subsidies for state exchanges. Politico Magazine asked leading thinkers in health care policy for their take on the future of the ACA and American health care. Is Obamacare here to stay? What will happen to the exchanges? And most important: Is the legal and political fight over? (6/25)

Chief Justice Roberts and Justice Anthony M. Kennedy both joined with the court’s liberal wing in endorsing the most reasonable reading of the statute, knowing they will face an angry backlash from the Obamacare-hating right. Perhaps the next time they deliver a ruling that disappoints the left, the default position should not be to question their good faith. ... It’s easy when disagreeing with a Supreme Court ruling, whether King v. Burwell or Citizens United, to dismiss it as the product of bad faith. Thursday’s ruling should encourage the court’s more strident critics to wonder who the real cynics are. (6/25)

People often think everyone in Washington is political. With its decision in King v. Burwell this morning, the Supreme Court (or at least some of its members) proved that's not always true. (Brianne J. Gorod, 6/25)

I'll pause to point out a cultural and political implication of this ruling and the drama leading up to it. Some supporters of the law declared that they were going to take their ball and go home if the Supreme Court didn't agree with their interpretation of the statute. These people wasted their time: With a 6-3 ruling, the call was not so close that the posturing pushed it over. But these people did have one effect. They eroded something in civic life that we can't afford to lose. By pretending that the Supreme Court and the rule of law were at risk in this ruling, they strained the already frayed fabric of civil society. (Megan McArdle, 6/25)

Conservatives are dismayed about the Supreme Court’s complicity in rewriting the Affordable Care Act — its ratification of the IRS’s disregard of the statute’s plain and purposeful language. But they have contributed to this outcome. Their decades of populist praise of judicial deference to the political branches has borne this sour fruit. ... The most durable damage from Thursday’s decision is not the perpetuation of the ACA, which can be undone by what created it — legislative action. The paramount injury is the court’s embrace of a duty to ratify and even facilitate lawless discretion exercised by administrative agencies and the executive branch generally. (George F. Will, 6/25)

The Supreme Court's decision Thursday in King vs. Burwell is a huge win for supporters of the Affordable Care Act. It's also a huge win for common sense in statutory interpretation. ... The Supreme Court's decision Thursday in King vs. Burwell is a huge win for supporters of the Affordable Care Act. It's also a huge win for common sense in statutory interpretation. ... As the chief justice rightly appreciated, the broader statutory context thus confirmed that Congress could not have meant what, taken out of context, it seems to have said. That's not rewriting the law. That's reading it. (Nicholas Bagley, 6/25)

Sometimes the Supreme Court moves in mysterious ways. The health care decision was not one of those times. A case that six months ago seemed to offer the court’s conservatives a low-risk opportunity to accomplish what they almost did in 2012 — kill the Affordable Care Act — became suffused with danger, for the millions of newly insured Americans, of course, but also for the Supreme Court itself. Ideology came face to face with reality, and reality prevailed. (Linda Greenhouse, 6/25)

Chief Justice John Roberts just saved the Affordable Care Act -- again. If you’re feeling déjà vu, you’re not alone. As he did in 2012, Roberts defected from his conservative colleagues and joined the court’s liberals in refusing to send Obamacare into a death-spiral. In King v. Burwell, Roberts has now cemented his reputation as a true believer in judicial restraint -- perhaps as the only justice who still believes in it. And this time, he was given cover by Justice Anthony Kennedy, making the vote 6-3. (Noah Feldman, 6/25)

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. (Yeomans, 6/26)

For the second time in three years, Chief Justice John Roberts has rewritten the Affordable Care Act in order to save it. Beyond its implications for health care, the Court’s 6-3 ruling in King v. Burwell is a landmark that betrays the Chief’s vow to be “an umpire,” not a legislator in robes. He stands revealed as a most political Justice. ... With the verve of a legislator, he has effectively amended the statute to read “established by the State—or by the way the Federal Government.” His opinion—joined by the four liberal Justices and Anthony Kennedy—is all the more startling because it goes beyond normal deference to regulators. (6/25)

The Supreme Court continued a trend Thursday morning toward making seemingly more liberal decisions. In two important cases, the court’s conservative majority was again split, putting liberal justices in the majority on decisions upholding the legality of certain subsidies to help Americans purchase insurance under the Affordable Care Act and offering legal protection against housing discrimination. Why are conservatives losing more often? While the justices may have changed their views in some instances, it’s also possible that the types of cases the court is deciding have shifted. What seem like liberal decisions may instead represent conservative overreach. (Brendan Nyhan, 6/25)

The Supreme Court has finally spoken. It never really needed to speak at all. The Court’s 6-3 decision to uphold federal subsidies under the Affordable Care Act was simple and emphatic, written by Chief Justice Roberts, no less. Justice Antonin Scalia’s dyspeptic dissent indicates the extent of the administration’s legal victory. Stock prices for the Hospital Corporation of America jumped approximately 8 percent with this decision, providing some sense of the economic havoc that might otherwise have ensued. I’m gratified by the outcome. But I remain saddened by the full history of this case. Cases such as King v. Burwell do not raise fundamental legal or policy challenges. Rather, they are naked invitations to crude judicial activism. (Harold Pollack, 6/25)