The Supreme Court today handed the Obama administration a major victory on health care, ruling 6-3 that nationwide subsidies called for in the Affordable Care Act are legal.

Today's decision comes three years after a bitterly divided high court upheld the Affordable Care Act as constitutional by a 5-to-4 vote.

As NPR's Nina Totenberg reported in March, opponents of the law contended "that the text of the law does not authorize subsidies to make mandated insurance affordable in 34 states."

At issue were six words in one section of the law. As Totenberg pointed out: "Those words stipulate that for people who cannot afford health coverage, subsidies are available through 'an exchange established by the state.'" She added:

"The government [contended] that those words refer to any exchange, whether it is set up by the state itself or an exchange run for the state by the federal government in accordance with individual state insurance laws and regulations. The challengers [said] the statute means what it says and no more."

Then, of course, it dawned on some that this is an election year. Throwing 6.4 million Americans in 36 states off the health system might be bad politics.

The bottom line is a paradox: what Democrats will publicly hail as a policy victory, Republicans will secretly recognize as delivery from a nasty political problem.

It's doubtful that political and legal attempts to subvert the ACA will cease. But Chief Justice John Robert's suggested a greater degree of finality than ever before when he wrote, "Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them."



Here's what a selection of New England's representatives in Congress had to say about the ruling.

If this were a horse race, U.S. Reps. Seth Moulton and Joe Kennedy III were the fastest out of the block with reactions to the decision on Twitter.

You got it, you can keep it! Millions of Americans still have health care!! #SCOTUS early this morning:

Generations in this country have fought for simple idea that health care is a right and not a privilege. Today #SCOTUS reaffirms. #ACA

Today’s #SCOTUS #ACA decision means millions of hardworking Americans will continue to have access to #healthcare

New Hampshire:

Unfortunately today's ruling doesn't address underlying problems w/ the law that are leading to higher premiums & deductibles

and less choice for Granite Staters. Rs & Ds should work together to enact real reforms that will make health care more affordable

Glad the #SCOTUS decision today will prevent millions of Americans from losing their health insurance! #KingvBurwell

BREAKING: #SCOTUS upholds federal healthcare exchanges. RT if you agree one-size-fits-all #Obamacare still isn't working.


I applaud the Supreme Court’s decision & hope that we can finally put discussions abt dismantling the #ACA behind us


The Supreme Court recognized the common-sense reading of the #ACA...

#SCOTUS recognizes that #ACA protects affordable health insurance for all Americans. #KingvBurwell #Obamacare

In the Chief Justice’s words, #SCOTUS decision today avoids “calamitous result” of 6.5 million Americans losing #healthcare. #ACA


#SCOTUS decision to uphold #ACA is great news for millions of Americans who are now guaranteed that they will have health insurance.

Glad to see #SCOTUS rule in favor of health care credits. #ACAworks for millions of Americans. Everyone has a right to affordable insurance.


Happy to be here on this historic day! #scotus #ACAWorks #mepolitics

Rhode Island:

SCOTUS should also be lauded for Fair Housing Act decision - a major win for civil rights today.

Great news for millions of Americans: today the Supreme Court ruled in favor of protecting affordable #healthcare. #KingvBurwell #ACAworks