In a 6-3 vote, the U.S. Supreme Court upheld the use of subsidies to buy health insurance on the federal health care marketplace, Healthcare.gov.
The central question was whether residents of Florida and 33 other states should be allowed to use their subsidies on an exchange their state did not set up for itself.
The case King v. Burwell was concerned with the line in the Affordable Care Act that states people can use subsidies if they are enrolled in “… an Exchange established by State…" and whether this precludes the federal government from offering its exchange when the state does not.
In Chief Justice John Roberts' majority opinion, he wrote that the phrase is ambiguous but must be taken in context and interpreted based on the “context and structure” of the law, especially in one that has “more than a few examples of inartful drafting.”
It’s the second time in three years the law survived the Supreme Court.
Here are six things you should know about the decision and how it affects Florida.
1. Nothing will change for those who get health care through Healthcare.gov.
People who have subsidies from healthcare plans on Healthcare.gov will not be affected. About 11.4 million people have signed up or have been automatically renewed for 2015 marketplace coverage, and about 87 percent of those are eligible for tax subsidies.
2. Florida has the most residents – 1.3 million – insured through the federal exchange who get subsidies.
But the decision affects other insurance consumers through their premium rates. Kaiser Health News reported that the alternative ruling would have increased premiums by 359 percent.
3. Gov. Rick Scott dropped his lawsuit against the federal government after the court’s ruling.
Scott sued the federal government, claiming it was coercing the state of Florida to expand Medicaid, which in 2012 the court ruled against.
Miriam Harmatz, a senior health law attorney at Florida Legal Services Inc., says the lawsuit was “a politically motivated action by the governor” and a “diversion from the critical issue” that more than 1 million people in Florida are uninsured.
4. Rep. Debbie Wasserman Schultz (D-Fla.) says it’s time for Republicans in Florida to move on.
“In my home state of Florida, Governor Rick Scott has had opportunities to expand Medicaid and provide 800,000 Floridians access to quality, affordable health care,” Schultz said in a prepared statement. “It is time for Governor Scott and the Republican State House to finally drop their political gamesmanship and help all Floridians.”
5. Republican presidential candidates Jeb Bush and Marco Rubio are against the Supreme Court’s decision.
Soon after the court upheld subsidies, Bush and Rubio issued statements.
“I disagree with the Court’s ruling and believe they have once again erred in trying to correct the mistakes made by President Obama and Congress in forcing Obamacare on the American people,” Rubio says.
Bush also says he is opposed to Obamacare in general.
“This is the direct result of President Obama. He deliberately forced Obamacare on the American people in a partisan and toxic way,” he says. “As president, I will uphold our Constitution, and I will not compromise my duty to you or the American people.”