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The U.S. Supreme Court on Thursday issued a 6-3 opinion upholding the eligibility of federal Health Insurance Marketplace enrollees to receive tax subsidies.

“The system as it’s been is intact; there are no changes to how it’s been working," said Eric Schneider, outreach and eligibility specialist for High Country Community Health. "Everyone’s going to continue to get their subsidies."

Chief Justice John Roberts authored the majority opinion, joined by Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan. Justices Antonin Scalia, Clarence Thomas and Samuel Alito dissented.

Petitioners in King v. Burwell challenged the government’s ability to extend subsidies to coverage purchased on the federal government’s exchange under the language of the Affordable Care Act. The law established a formula for determining tax credits purchased through an exchange “established by the state,” and challengers argued this means the subsidies are only for plans on the 16 state-operated exchanges.

But the majority of justices found that the language of the ACA was ambiguous and meant to be construed in reference to federally run exchanges, as well as the state-run exchanges.

"The combination of no tax credits and an ineffective coverage requirement could well push a state’s individual insurance market into a death spiral," the majority opinion said. "It is implausible that Congress meant the act to operate in this manner."

"Petitioners’ plain-meaning arguments are strong, but the act’s context and structure compel the conclusion that Section 36B allows tax credits for insurance purchased on any exchange created under the act," the opinion further said. "Those credits are necessary for the federal exchanges to function like their state exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid."

The Obama administration and others lauded the decision on Thursday.

"If the court had ruled that North Carolinians are ineligible for subsidies to help them pay for their health insurance, there would have been chaos in our market," North Carolina Insurance Commissioner Wayne Goodwin said in a statement. "This ruling provides more stability for policyholders and the insurance industry, and I am relieved that hundreds of thousands of people in our state will not lose their coverage."

Others, including U.S. Rep. Virginia Foxx (NC-5th District) continued to argue that the ACA has been ineffective and should be repealed.

“Despite its central promise, the Affordable Care Act has proved to be anything but affordable for many North Carolinians, and today’s Supreme Court decision doesn’t change that fact,” Foxx said. “Rather than making piecemeal fixes, the best approach to solving the multitude of problems resulting from Obamacare is to unite behind a complete repeal of the law and replace it with solutions that lower costs and empower patients to choose the care that’s right for them.”

Melissa Selby, executive director of the Community Care Clinic in Boone, agreed that the ACA has not provided affordable health insurance for everyone.

"While this was a victory for the (Obama) Administration and those who received coverage through this program, the hard fact remains that there are still millions of individuals who still do not have access to affordable health care and health insurance," Selby said. 

"Free and charitable clinics remain a very critical part of the health care system in our country providing help to those living without access to affordable health care, mental health care, dental care and prescription access," she added. "Daily, our clinics hear heartbreaking stories from patients about how health care remains unobtainable even though those stories are not heard in the mainstream media. Even more disheartening is that 70 percent of our clinics are reporting that patients are returning to them for help even after they have signed up for insurance coverage, due to issues with having timely access to a doctor, access to affordable medication and more."

http://www.wataugademocrat.com/news/chaos-avoided-scotus-upholds-aca-subsidies/article_e2eac440-1b4e-11e5-a4b5-d712affa388b.html