SCOTUS did what many people figured they would do; with Chief Justice Roberts, yet again, joining the bench legislatures in a veiled effort to avoid the impression of a 5-4 ideological court.

SCOTUS – Today, by a vote of six to three, the Court agreed with the Obama administration that the subsidies are available for everyone who bought health insurance through an exchange, no matter whether that exchange was created by a state or the federal government.

Chief Justice John Roberts wrote the Court’s opinion, which Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan all joined.

The Court acknowledged that, at first blush, the phrase “established by the State” does not appear to include the federal government. After all, the ACA specifically defines “State” as “each of the 50 States and the District of Columbia.” But other parts of the law, the Court explained, suggest that the “meaning of the phrase ‘established by the State’ is not so clear.”

For example, one provision that defines who is qualified to purchase insurance on an exchange refers to an individual who “resides in the State that established the Exchange” – which on the plaintiffs’ reading would mean that no one would be qualified to buy health insurance on exchanges established by the federal government.

And if the phrase “established by the State” is in fact not clear, the Court continued, then the next step is to look at the Affordable Care Act more broadly to determine what Congress meant by the phrase. And when you do that, the Court reasoned, it becomes apparent that Congress actually intended for the subsidies to be available to everyone who buys health insurance on an exchange, no matter who created it.

If the subsidies weren’t available in the states with federal exchanges, the Court explained, the insurance markets in those states simply wouldn’t work properly: without the subsidies, almost all of the people who purchased insurance on the exchanges would no longer be required to purchase insurance because it would be too expensive. This would create a “death spiral,” in which insurance premiums would go up and enrollment would go down.

It is “implausible,” the Court concluded, “that Congress meant the Act to operate in this manner.”

Justice Antonin Scalia dissented, in an opinion joined by Justices Clarence Thomas and Samuel Alito that began by describing the majority’s conclusion as “quite absurd.” The tone only gets even more strident from there, with Scalia lamenting that “words no longer have meaning if an Exchange that is not established by the State is ‘established by the State.’”

And he concludes by complaining that the majority’s opinion– as it did three years ago in upholding the individual mandate – “changes the usual rules of statutory interpretation for the sake of the Affordable Care Act.” Perhaps, he suggested, “We should start calling this law SCOTUScare.” (more)

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