The Supreme Court ruled on Thursday that President Obama’s health care law allows the federal government to provide nationwide tax subsidies to help poor and middle-class people buy health insurance, a sweeping vindication that endorsed the larger purpose of Mr. Obama’s signature legislative achievement.
The 6-to-3 ruling means that it is all but certain that the Affordable Care Act will survive after Mr. Obama leaves office in 2017. For the second time in three years, the law survived an encounter with the Supreme Court. But the court’s tone was different this time. The first decision, in 2012, was fractured and grudging, while Thursday’s ruling was more assertive.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John G. Roberts Jr. wrote for a united six-justice majority. In 2012’s closely divided decision, Chief Justice Roberts also wrote the controlling opinion, but that time no other justice joined it in full.
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.
“We really should start calling this law Scotus-care,” Justice Scalia said, to laughter from the audience.
In a hastily arranged appearance in the Rose Garden on Thursday morning, a triumphant Mr. Obama praised the ruling. “After multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay,” he said, adding: “What we’re not going to do is unravel what has now been woven into the fabric of America.”
The ruling was a blow to Republicans, who have been trying to gut the law since it was enacted. But House Speaker John A. Boehner vowed that the political fight against it would continue.
“The problem with Obamacare is still fundamentally the same: The law is broken,” Mr. Boehner said. “It’s raising costs for American families, it’s raising costs for small businesses and it’s just fundamentally broken. And we’re going to continue our efforts to do everything we can to put the American people back in charge of their health care and not the federal government.”
The case concerned a central part of the Affordable Care Act that created marketplaces, known as exchanges, to allow people who lack insurance to shop for individual health plans. Some states set up their own exchanges, but about three dozen allowed the federal government to step in to run them. Across the nation, about 85 percent of customers using the exchanges qualify for subsidies to help pay for coverage, based on their income.
The question in the case, King v. Burwell, No. 14-114, 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.”
A legal victory for the plaintiffs, lawyers for the administration said, would have affected more than six million people and created havoc in the insurance markets and undermined the law.
Chief Justice Roberts acknowledged that the plaintiffs had strong arguments about the plain meaning of the contested words. But he wrote that the words must be understood as part of a larger statutory plan. “In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”