Some 40,000 Iowans will continue to receive federal subsidies for purchasing health insurance, thanks to a 6-3 U.S. Supreme Court opinion announced today. Plaintiffs in King v Burwell had argued that Congress intended for subsidies to be available only to Americans who purchased health insurance through state-run exchanges. Chief Justice John Roberts rejected that interpretation in his opinion (pdf), joined by Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan. Amy Howe explained the ruling in “plain English” at the SCOTUS blog, where Lyle Denniston wrote a separate analysis of the opinion.

Dissenting Justice Antonin Scalia accused his colleagues of changing “usual rules of statutory interpretation for the sake of the Affordable Care Act,” as the Supreme Court majority did (in his view) when it upheld the individual mandate to purchase health insurance in 2012.

A ruling for the plaintiffs in King v Burwell would not only have threatened health care access for roughly 6.4 million people who receive subsidies for health insurance purchased through the federal website Healthcare.gov. It could have caused cascading effects such as sharp premium increases for millions of Americans who do not qualify for subsidies but would nevertheless have been priced out of the health insurance market. In theory, Congress could have fixed the problem with a one-paragraph bill clarifying that people who buy insurance through the federal exchange qualified for subsidies, but most House and Senate Republicans appeared unwilling to go that route.

Today’s Supreme Court decision removes the only remaining threat to federal health insurance subsidies for eligible Iowans. Last month, several insurance companies applied to offer policies for 2016 to Iowans through the exchange. Only one provider did so for 2015, and if that company had pulled out of Iowa, health insurance subsidies would not have been available to anyone in our state for next year.

UPDATE: Added Iowa political reaction below. Note that several of the Republican statements renew a vow to repeal and replace “Obamacare.” Though destroying the system created by the 2010 health care reform law was transparently the goal of the King v Burwell plaintiffs, their lawyers maintained the charade that the lawsuit was only about getting the Obama administration to follow the Affordable Care Act.

Statement released by the Iowa Insurance Division:

           June 25, 2015 – The Iowa Insurance Division has released the following statement regarding today’s Supreme Court decision in the case of King vs. Burwell.

           “The Iowa Insurance Division is currently reviewing the Supreme Court’s decision but it appears from early news reports that Iowans currently receiving tax credits while using the federal health exchange will be able to continue doing so,” Iowa Insurance Commissioner Nick Gerhart said.

           The latest figures regarding use of the federal health exchange, healthcare.gov, provided to the Iowa Insurance Division from the U.S. Department of Health & Human Services are from March and show that 45,162 Iowans (pg.46) used the federal health exchange to get coverage. 86% of those individuals received a tax credit to help pay for their coverage (pg.46).  The average monthly tax credit was $260 (pg. 50).

Statement from Senator Joni Ernst:

WASHINGTON, D.C. – Senator Joni Ernst (R-IA) released the following statement after the Supreme Court issued a ruling in King v. Burwell. The court sided with the Obama administration and upheld the IRS regulation that provides subsidies to individuals who buy health insurance on a federal exchange setup by ObamaCare.

“Today’s Supreme Court ruling does not change the fundamental reality that ObamaCare is a poorly conceived and reckless law.

“As ObamaCare again finds itself under scrutiny of our highest court, it’s further affirmation that we need a workable solution for the millions of Americans who continue to face uncertainty over their health care due to this disastrous law.

“I remain committed to working towards a sustainable health care system that puts the focus back on Iowa families and individuals, which is why I support repealing and replacing ObamaCare with affordable, patient centered alternatives. I will continue working to help Iowans achieve the care they deserve that enhances competition, increases flexibility, constrains rising costs and ensures Americans have a voice over their own health care.”

Statement from Senator Chuck Grassley:

Sen. Chuck Grassley of Iowa today made the following comment on the Supreme Court’s ruling in King v. Burwell on the President’s health care law.

“I respect the court and its role in our system of government, but Obamacare remains a terrible law.  It’s led to too many people losing the coverage they had and spending more for what coverage they can get.  Iowans tell me directly in town meetings and in emails and letters to my office that they don’t like the law.  Obamacare upended the whole health system instead of targeting what was wrong and fixing those problems.  Now the debate returns to the Congress and next year’s presidential election.  I’m committed to replacing Obamacare with health care reforms that empower consumers, drive down costs, and use marketplace incentives to make health care coverage accessible and affordable.  The current majority in Congress is committed to repealing Obamacare and replacing it with effective reforms driven by the marketplace, not the heavy hand of government.”

Representative Steve King issued this video statement rather than a traditional press release.

E-mail blast from the Young for Iowa campaign:

Friends –

Like you, I’m terribly disappointed in the Supreme Court’s actions today. However, it won’t roadblock my fight to restore patient-centered health care on behalf of Iowans.

Will you stand with me in the fight against the federal take over of our health care with a contribution of $10, $25, $50, $100 or $250?

This failed law takes away choices, imposes significant costs, fails to solve the overall problems within our system, and is unsustainable.

If you agree, pitch in $10, $25, $50 or whatever you can today.

I’m standing up to the big government bureaucrats dictating our health care. Will you stand with me?

Thank you,

David

Iowa Democratic Party press release:

Des Moines-Iowa Democratic Party Chair Dr. Andy McGuire released the following statement following the Supreme Court’s ruling to protect the subsides that allow tens of thousands of Iowans to purchase health insurance through the Affordable Care Act:

“Once again, the Supreme Court ruled in favor of the tens of thousands of Iowans receiving health care because of the Affordable Care Act.  Never again shall we return to the days when you could be denied health coverage because of a pre-existing condition, or be charged more for health insurance merely because of your gender. Every Iowan deserves access to quality, affordable health care.

“The time for political posturing on the issue from the 2016 GOP field and Republicans across Iowa is well past its expiration date. The Republicans coming to our state with no message beyond repeal and denying health care to thousands of Iowans must stop. Now, Iowans will continue to move forward to ensure all of our families can live safe and healthy lives.”

Excerpt from a Republican Party of Iowa press release:

DES MOINES – The Iowa GOP released the following statements following the King vs. Burwell Supreme Court decision this morning.

Chairman Jeff Kaufmann: “Obamacare was conceived through a coordinated campaign to deceive the public, leaving Americans with canceled policies, increased costs, and fewer freedoms. We will continue fighting to repeal and replace Obamacare, and we’ll start by electing a Republican to the White House in 2016.

Statement from Co-Chair Cody Hoefert: “Hillary Clinton unquestioningly supports Obamacare, throwing into sharp contrast the decision facing Iowa in 2016. Here in Iowa there could be a 25% increase in our healthcare premiums just this year alone, a steep price to pay for this lackluster law.”

Press release from the Iowa House Democrats:

Statement from Iowa House Democrats on Today’s U.S. Supreme Court’s Decision Regarding Affordable Health Care

As ranking members of the human services policy and budget committees, we agree with the ruling of the United States Supreme Court today.  This is good news for low income Iowans, our exceptional health care providers, and Iowa’s effort to become the healthiest state in the nation.

Had the Supreme Court ruled in an adverse manner, more than 45,000 Iowans would have lost their health insurance coverage.  Today’s ruling continues to ensure Iowans receive affordable access to high quality health care through the Marketplace and the Iowa Health and Wellness Plan.

It is time to move forward and do everything we can to continue to provide affordable health care to all Iowans.