June 25, 2015 – Washington, District of Columbia, U.S. –Supporters at the U.S. Supreme Court rally in support ofObamacare.The court ruled 6-3 in King vs Burwell that language in the law wasconstitutional.

Obamacare has been saved yet again by the Supreme Court.

The Supreme Court ruled 6-3 June 25 that the subsidies under thePatient Protection and Affordable Care Act will stay.

The ruling upholds a major tenet of the health care law enablingmillions of Americans to keep the tax subsidies that help them buyand afford health coverage under the law.

Chief Justice John Roberts wrote the court's majority opinionand was joined by Justices Anthony Kennedy, Ruth Bader Ginsburg,Stephen Breyer, Sonia Sotomayor and Elena Kagan.

Should the Court have struck down the subsidies, it would havehad disastrous effects for the health care market and the healthreform law. An estimated 6.4 million Americans receive thesubsidies in the 34 states that don't have their own exchanges.Reports had suggested millions would lose coverage and millionsmore would suffer from exploding premiums had the government lostin King v. Burwell.

The Supreme Court agreed.

“The combination of no tax credits and an ineffective coveragerequirement could well push a State's individual insurance marketinto a death spiral. It is implausible that Congress meant the Actto operate in this manner,” Roberts wrote.

King v. Burwell ultimately hinged on just fourwords—“established by the state”—as it called into question thelegality of federal exchanges. While PPACA challengers said thatphrase limits the tax credits to the 16 states that have set uptheir own exchanges, the Obama administration repeatedly defendedan IRS rule that interpreted the law as allowing subsidiesnationwide.

The case represented the biggest legal threat to PPACA since thelaw was challenged in the Supreme Court three years ago. Then, thecourt upheld the law's centerpiece, the individual mandate, as atax by a 5-4 vote, but left Medicaid expansion up to thestates.

The Obama administration also did not have a backup plan had thesubsidies been gutted.

Ultimately, this was the decision most had hoped for: Poll afterpoll found that the public backed the subsidies and wanted thecourt to uphold all the law's subsidies, regardless of whether theysupported PPACA in general.

Many in the industry praised the decision.

The National Business Group on Health said the ruling was“welcome news” to large employers in “affected states which haverelied on exchanges for health insurance for early retirees,part-time employees, and other employees.”

“Millions of Americans, including employees, retirees and theirfamilies can now rest assured that they will continue to haveaccess to federal subsidies that help keep their health insurancecoverage affordable,” said Brian Marcotte, NBGH President and CEO.“It also reassures employers in affected states which have reliedon exchanges for early retirees, part-time employees and otheremployees, that there will be no disruption in coverage.”

Despite the administration's victory, analysts do not see thisbeing the end of controversy for PPACA.

“Affordable Care Act implementation returns to normal following[the] ruling but debate over the law is likely far from over,” saidElizabeth Carpenter, director at consulting firm Avalere Health.“Congress may still pursue strategies to alter the Affordable CareAct, and the debate over reform is likely to reignite as part ofthe 2016 presidential race.

“Congress is still likely to consider repeal of the medicaldevice tax and the Independent Payment Advisory Board, as well aschanges to the employer mandate and the Cadillac tax.”