The U.S. Supreme Court upheld a crucial interpretation of the Affordable Care Act on Thursday, preserving health insurance for more than 1 million Floridians but providing no larger solutions to the national or statewide divisions on the law.
In a case that hinged on what Congress meant by making tax credits for insurance available to people using "an Exchange established by the State," a majority of justices found that credits could be given to people who purchase coverage through an exchange set up by the federal government if the state doesn't operate one.
The 6-3 opinion makes health care more affordable for millions of people across the country, including Floridians. Without the tax credits, many Americans' incomes would be considered too low to afford insurance policies, and those citizens would be exempt from the individual mandate contained in the law, commonly known as Obamacare.
Like in 33 other states, Floridians get coverage through a health exchange set up and run by the secretary of the U.S. Department of Health and Human Services. More than 1.3 million Floridians buy their insurance through that marketplace.
"This historic decision benefits more families in Florida than anywhere else in the nation," said Mark Ferrulo, executive director of Progress Florida, a liberal advocacy group. "More than a million Floridians will continue to save over $3,000 each through tax credits and cost-sharing reductions that enable them to afford health coverage."
But nationally and in Florida, opponents seemed to not be backing down on arguments that the law is unworkable and that the coverage it provides is inadequate.
"The Supreme Court ruling does not change the fact that Obamacare is a fundamentally broken law and has been since day one," said U.S. Rep. Ander Crensaw, R-Fla. "Floridians and all Americans should know that Republicans will continue to build a bridge for them to cross over its turbulent waters to safe shores once and for all."
Writing for the majority, Chief Justice John Roberts said other parts of the law made it clear that federal exchanges were supposed to function largely like marketplaces run by states.
"But state and federal exchanges would differ in a fundamental way if tax credits were available only on state exchanges – one type of exchange would help make insurance more affordable by providing billions of dollars to the states' citizens; the other type of exchange would not," Roberts wrote.
He was joined by Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan.
In a sharply-worded dissent, Justice Antonin Scalia accused the court of twisting provisions of the law to preserve the Affordable Care Act. Scalia also dissented in a 2012 case that upheld the constitutionality of the act.
"Today's opinion changes the usual rules of statutory interpretation for the sake of the Affordable Care Act. That, alas, is not a novelty. ... We should start calling this law SCOTUScare," Scalia wrote in an opinion joined by Justices Clarence Thomas and Samuel Alito.
Scalia also wrote "I dissent" at the end of his opinion, instead of the customary "I respectfully dissent."
In Washington, D.C., officials with the Obama administration said the decision should settle the debate over the still-controversial law.
"The ACA is part of the fabric of America, and now that the highest court in the land has upheld it twice, the time has come to turn to building on the progress that we've made," U.S. Health and Human Services Secretary Sylvia Burwell said during a conference call with reporters.
Supporters of the law in Florida said the state Legislature should reconsider whether to expand Medicaid under a separate provision of the law. The state Senate put forward a plan that would use Medicaid expansion funds to help low-income Floridians purchase private insurance, but that idea was rejected by the House and is strongly opposed by Gov. Rick Scott.
"It's time for the opponents, including Governor Scott, to accept the fact that the Affordable Care Act is the law of the land, and their best efforts have failed to undermine it," said state Senate Minority Leader Arthenia Joyner, D-Tampa. "Both he and the House Republican leadership need to put down their calls for war, and unblock health-care expansion for the additional 1 million uninsured Floridians still waiting for affordable insurance to reach them."
But groups such as the conservative Americans for Prosperity-Florida signaled that the health-care debate will continue, issuing a statement that blasted Obamacare and vowing to "fight for real, patient-centered health-care reform."
"Six years after Obamacare was passed and the law continues to drive up health-care costs and restrict access to care,'' Chris Hudson, the group's state director, said. "The U.S. Supreme Court's decision today will not change anything."