Nursing Group Praises Supreme Court Ruling Upholding Key Affordable Care Act Provision

The US Supreme Court ruled today to uphold a pivotal provision of the Affordable Care Act (ACA) providing subsidies for individuals on the federally facilitated marketplace. The landmark 6-3 ruling preserves the tax credits that have allowed millions of Americans to purchase health insurance.

“We are gratified that the Supreme Court ruling will avoid the loss of subsidies that have allowed millions of people to get healthy and stay healthy,” said Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA) in a statement released shortly after the ruling. “The Supreme Court has spoken. Now it’s time to finish the work of ensuring Americans get the healthcare they need by expanding Medicaid.”

ANA noted that the share of adults without health insurance dropped to its lowest level in 7 years in 2014 as the ACA took full effect. Without the tax credits, many people would have been unable to obtain health insurance, thus limiting their access to routine preventive care and causing insurance costs to rise due to a sicker population. ANA joined an amicus (friend of the court) brief in support of the US Department of Health and Human Services, the respondent in the Supreme Court case.

The case before the high court hinged upon the interpretation of six words present in the ACA legislation: “an Exchange established by the State.” The plaintiffs argued that a plain reading of the ACA means that subsidies should only be available to consumers who live in states that set up their own exchanges, but the majority of justices were not persuaded.

"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," said Chief Justice John Roberts, in the majority opinion.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter," Roberts wrote. "Section 36B can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt."

Roberts was joined in the majority by justices Anthony Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor, Elena Kagan, and Stephen Breyer. Justices Antonin Scalia, Clarence Thomas, and Samuel Alito dissented. The full opinion can be accessed here.

The Cancer Support Community also released a statement praising the Supreme Court’s decision: “Had the court ruled in favor of the plaintiffs, millions of people who receive their health insurance through the federal exchange would have lost access to their subsidies. This would have resulted in a drastic increase in health insurance cost for millions of Americans.”