TALLAHASSEE — In a decision that upheld federal health insurance subsidies for 1.3 million Floridians, the U.S. Supreme Court on Thursday validated a key provision in President Barack Obama’s Affordable Care Act, ruling that states like Florida can use a federal insurance exchange to provide subsidized coverage to residents.
The 6-3 opinion, written by Chief Justice John Roberts, endorsed the use of federal exchanges that are used in 34 states, with the other states using state exchanges to provide health insurance under the ACA, also known as Obamacare.
In the latest serious challenge to the landmark 2010 law, opponents asserted the federal tax-credit subsidies — which cover some 6.4 million people nationally in federal exchanges — should only be provided through state exchanges. The tax credits were designed to help low- and moderate-income people cover the cost of health insurance.
Roberts said the law clearly intended the subsidies to be available nationwide.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote. “If at all possible, we must interpret the act in a way that is consistent with the former, and avoids the latter.”
In the dissent, Justice Antonin Scalia said the court majority was ignoring a plain interpretation of the law’s requirement that health insurance under the ACA be purchased through exchanges “established by the state.”
“Rather than rewriting the law under the pretense of interpreting it, the court should have left it to Congress to decide what to do about the act’s limitation of tax credits to state exchanges,” Scalia wrote.
Roberts, who wrote the 2012 opinion originally upholding the ACA, was joined by Justices Sonia Sotomayor, Ruth Bader Ginsburg, Stephen Breyer, Elena Kagan and Anthony Kennedy. The dissent included Scalia and Justices Samuel Alito and Clarence Thomas.
Either way the ruling went, it would have had a profound impact in Florida, the nation’s third-largest state with the largest number of residents subsidized through a federal exchange. About 93 percent of the 1.3 million Floridians who signed up for coverage in the federal exchange this year received subsidies, according to data from the U.S. Department of Health and Human Services.
It includes some 36,000 people who live in the congressional district represented by Vern Buchanan, R-Longboat Key, and covers Sarasota and Manatee counties, according to Families USA.
The ruling will allow those Floridians to keep the average health insurance monthly premium of $88 with the subsidies and avoid a potential jump to $376 per month without the subsidies, which would have likely meant many residents would have dropped their coverage as unaffordable.
“This historic decision benefits more families in Florida than anywhere else in the nation,” said Mark Ferrulo, head 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.”
The court decision will also have widespread policy and political implications in Florida, which again is poised to be the nation’s largest swing state in next year’s presidential elections, where the federal health care law will remain a sharp dividing line between the Republican and Democratic contenders.
In the short term, the ruling averts another politically charged health care debate involving the Florida Legislature and Gov. Rick Scott, who had not made any preparations for the potential demise of a federal insurance exchange. Lawmakers just came through nearly three months of a session and special session where the House and Senate were divided over a plan to expand Medicaid coverage under the ACA.
Scott, who had joined the House in opposing the Medicaid expansion that failed, had made it clear he opposed creating a state exchange.
But Democrats and Senate leaders used Thursday’s decision to renew their call for a health care expansion plan that would cover some 800,000 or more Floridians who make too much to qualify for Medicaid but enough to pay for a subsidized policy.
“Florida dodged a massive bullet with the ruling today and 1.3 million residents now have the high court’s affirmation that their health insurance will remain within reach,” said Senate Democratic leader Arthenia Joyner of Tampa. “It’s time for the opponents, including Gov. 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.”
Senate President Andy Gardiner, R-Orlando, called the court ruling “welcome news” for the state, but said Florida must still address the issue of low-income, working residents who fall into the coverage gap.
“The Senate remains committed to addressing this serious health care problem through a free-market Florida solution that maximizes consumer choice and personal responsibility, while protecting state sovereignty,” Gardiner said, adding he wants to work with Scott and the House on “a compromise plan.”
But most Republicans leaders, including Florida’s two presidential contenders, said they will continue to challenge the law, which they see as detrimental to Florida and the nation.
“Despite the court’s decision, Obamacare is still a bad law that is having a negative impact on our country and on millions of Americans,” said U.S. Sen. Marco Rubio, R-Miami. “I remain committed to repealing this bad law and replacing it.”
Rubio has advanced a plan that would provide tax credits for health insurance purchases and allow insurance policies to be purchases across state lines.
Former Gov. Jeb Bush said the court ruling “is not the end of the fight against Obamacare.”
If elected, Bush said he would “work with Congress to repeal and replace this flawed law with conservative reforms that empower consumers with more choices and control over their health care decisions.”
Florida’s only statewide elected Democrat, U.S. Sen. Bill Nelson, said the nation’s highest court “made the correct ruling.”
“Hopefully, some of the extremists will now stop trying to dismantle the law and instead join us in trying to improve it where needed,” Nelson said.
EARLIER: With 1.3 million residents receiving federal health insurance subsidies, Florida may be the big winner in today’s U.S. Supreme Court ruling upholding the federal insurance exchanges that provide the subsidies.
In a 6-3 ruling, written by Chief Justice John Roberts, the court endorsed the use of federal exchanges that are used in 34 states, with the other states using state exchanges to provide health insurance under the federal Affordable Care Act.
Opponents had challenged the law asserting it said the tax-credit subsidies _ which cover some 6.4 million people nationally _ should only be provided through state exchanges.
But Roberts said the law clearly intended the subsidies to be available nationwide.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote. “If at all possible, we must interpret the act in a way that is consistent with the former, and avoids the latter.”
In the dissent, Justice Antonin Scalia said the court majority was ignoring a plain interpretation of the law’s requirement that health insurance under the ACA be purchased through exchanges “established by the state.”
“Rather than rewriting the law under the pretense of interpreting it, the court should have left it to Congress to decide what to do about the act’s limitation of tax credits to state exchanges,” Scalia wrote.
About 93 percent of the 1.3 million Floridians who signed up for coverage this year received subsidies, according to data from the U.S. Department of Health and Human Services.
It includes some 36,000 people who live in the congressional district represented by Vern Buchanan, R-Longboat Key, and covers Sarasota and Manatee counties, according to a report from Families USA.
The ruling will allow Floridians to keep the average health insurance monthly premium of $88 with the subsidies and avoid a potential jump to $376 per month without the subsidies, which would have likely meant many residents would have dropped their coverage as unaffordable.
The court’s decision also averts another politically charged health care debate involving the Florida Legislature and Gov. Rick Scott, who had not made any preparations for the potential demise of a federal insurance exchange, even though Florida had the most residents in the nation of any state covered by a federal exchange.
Scott, like many other Republican governors, had made it clear he opposed creating a state exchange.
Rep. Mia Jones, D-Jacksonville, said the court made “the right decision” in upholding the federal exchanges in Florida and 33 other states.
“I’m especially happy with the court’s ruling because, if the outcome would have been different, Republican leadership in Florida _ particularly Gov. Rick Scott _ had done nothing to prepare for such an outcome,” Jones said. “Even though that negligence is fact, I’m glad it won’t harm anyone.”
But opponents of the ACA, which they call Obamacare, said they will continue to challenge the law, which they see as detrimental to Florida and the nation.
“Despite the court’s decision, Obamacare is still a bad law that is having a negative impact on our country and on millions of Americans,” said U.S. Sen. Marco Rubio, R-Miami, who is running for president next year. “I remain committed to repealing this bad law and replacing it.”
Rubio has advanced plan that would provide tax credits for health insurance purchases and allow insurance policies to be purchases across state lines.
