Supreme Court ObamaCare | Ruling on ObamaCare

A Summary of Supreme Court Cases Pertaining to the Affordable Care Act

Supreme Court ObamaCare; ObamaCare has been taken to the Supreme Court once already for repeal. Aside from ObamaCare’s Supreme Court rulings, the Affordable Care Act has seen over 50 repeal attempts by the house and senate.

IMPORTANT UPDATE: A Texas federal judge ruled the Affordable Care Act (Obamacare) unconstitutional on Dec 14 2018. Then in late March the DOJ affirmed their support for the ruling. The case will now go into the appeals courts. For now nothing changes as the legal process play out. However, there could be real consequences down the road. Learn more about the 2018 ObamaCare ruling.

IMPORTANT UPDATE: The Supreme Court ruled 6-3 on June 25, 2015, that subsidies were legal. The IRS will be able to issue subsidies on behalf of those who bought a plan through HealthCare.Gov after the plaintiffs in King V. Burwell lost their challenge. Read about the King V. Burwell Ruling to uphold subsidies here.

Was ObamaCare Repealed?

Despite ongoing opposition, the Affordable Care Act remains “the law of the land” after being upheld by NFB V Sebelius, a case heard and ruled on in 2012.

In 2015 fate of subsidies hinged on King V Burwell, a case that argued subsidies obtained through HealthCare.Gov were illegal. The Supreme Court has heard arguments for King V Burwell on March 4th, 2015 and ruled for subsidies on June 25, 2015.

The Affordable Care Act survived both of these major repeal attempts and the law and its provisions were confirmed to be Constitutional by the Supreme Court.

With that said, another case in Dec 2018 ruled the ACA unconstitutional, and this ruling has not yet been resolved. So the fate of the ACA hangs in the air as the legal process plays out.

We further explain the major and minor repeal attempts that made it to the Supreme Court below. This page does not focus on the unresolved case from 2018 (that will be added in as we learn more).

The Two Major Supreme Court Lawsuits

There have been two major Supreme Court lawsuits about the Affordable Care Act that could have resulted in the repeal or dismantling of the law. They are:

  1. The 2012 NFIB V Sebelius case (discussed below) – Ruled for the ACA with some changes
  2. The 2015 King V Burwell case was ruled for ACA. The Supreme Court Upheld subsidies declaring them legal. Read the King V Burwell ruling from the Supreme Court here.
You can see the full list of ObamaCare lawsuits here, including information on the Hobby Lobby lawsuit. If you are looking for information on King v. Burwell (the subsidy lawsuit), go here. Aside from the two major cases, four other cases brought to the Supreme Court include the Hobby Lobby case and other similar lawsuits aimed at the requirement for employers to provide contraceptive coverage. The most recent contraceptive lawsuit, Michigan Catholic Conference v. Burwell, ruled for the plaintiff.

ObamaCare Supreme Court Ruling UPHOLDS Health Care Reform

The decision on the ObamaCare ruling by the Supreme Court in National Federation of Independent Business v. Sebelius was decided on June 28, 2012. The Supreme Court ObamaCare ruling was a 5-4 ruling to uphold the Affordable Care Act. The final ruling on ObamaCare had a few implications, ranging from ObamaCare being defined as a tax and not a mandate to a choice for States to opt-out of Medicaid Expansion.

Supreme Court ObamaCare Ruling

The Supreme Court upheld ObamaCare on June 28, 2012. The final ruling on ObamaCare was a made by Supreme Court Judge Vinson. The basic idea of the ruling was that ObamaCare was declared a tax and not a mandate, and was therefore declared constitutional.

The ruling also let states opt-out of expanding Medicaid. Almost half of the U.S. States opted out of expanding Medicaid in 2014 (as of October 2013) leading to 5.9 million of our nation’s poorest without access to affordable health insurance.

Here are the President’s official statements on the ruling:

What Does the Ruling Mean to ObamaCare?

The good news is that ObamaCare (the Patient Protection and Affordable Care Act), which passed in 2010, remains the law (albeit with some modifications). However, during the ObamaCare Supreme Court ruling, some important aspects of the health care bill were lost. The biggest loss in the ruling was to Medicaid, and it has mostly slipped under the radar but will greatly affect America’s poorest 7%.

obamacare supreme courtObamaCare Supreme Court Ruling: The NFIB V. Medicaid

The National Federation of Independent Business (NFIB) v. Sebelius (the official name of the ObamaCare Supreme Court Ruling on ObamaCare) ruling upheld most of the Affordable Care Act. However, a few changes were made, most importantly on Medicaid. The NFIB, which claims to represent independent businesses but has constantly been accused of being a big-business-backed organization and going after programs that help both America’s smallest businesses and the working poor, raised enough funds to get their repeal of ObamaCare to the Supreme Court.  NOTE: the ACA provides big subsidies to small businesses with less than 25 full-time equivalent employees and those making less than $40,000 a year.

The ruling on Medicaid allows states to reject Medicaid for their poorest (roughly 7% of the population or 5.9 million people). Even though giving states a choice in how they handle Medicaid may not seem like a big deal, this was a major victory for those who seek to repeal ObamaCare. It is much easier to fight laws at a state level. This means that anti-Obamacare states (Red states and some swing states) can deny health insurance to their constituents and thereby keep folks from seeing the new law in a favorable light. These changes will also increase the cost of ObamaCare for the rest of America by putting extra pressure on federal tax dollars to cover those who states let slip between the cracks (as Medicaid is a joint funded program between federal government and state). Meanwhile, the tax credits some of these folks will use to get coverage is funded only by the federal government.

ObamaCare Supreme Court Ruling: A Tax not a Mandate

Although most of the law will be upheld, the other major change is a matter of semantics. ObamaCare will no longer be a mandate (meaning Americans must buy health insurance, which keeps the cost down for all Americans). Instead, Obamacare will be a tax, meaning that those who opt out must pay a tax and those who opt in will receive tax breaks. This doesn’t change how ObamaCare affects the average American, but it does have an impact on how the courts will treat the law moving forward.

Justice Roberts on ObamaCare as a Tax Not a Mandate

Although ObamaCare was almost struck down due to some semantics over the difference between a tax, a penalty, and a mandate, the final ruling was summed up by Chief Justice Roberts:

“The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”

ObamaCare is Upheld by the Supreme Court, for Now

Although the Affordable Care Act was upheld by the Supreme Court ruling, we should all keep in mind that upcoming elections will have a major impact on the success of reforming health care and health insurance in the United States. If the Affordable Care Act is given a chance to grow, many will see the benefits of reforming our system. If it is dismantled before it can have a more significant impact on America, further improvements to our healthcare system will only be harder to implement.

Aspects of ObamaCare that Remain Largely Unchanged By Supreme Court Ruling

ObamaCare is safe for now. Here are some aspects of the law that will help your family:

1. Americans Getting Health Care Through Their Employer:  Under the Affordable Care Act, all Americans are required to have insurance. That means companies must either provide their workers with health insurance or deem that it would be cheaper to subsidize them and let them get health insurance through the state. In most cases, this will have little impact on you financially (although you just may be saving money). The major difference is that some people will have additional protections provided by the supreme court’s ruling on health care reform – namely, no limits or restrictions on benefits, no annual limits, and a few other protections detailed in the Affordable Health Care and Patient Protection Acts.

2. American’s Receiving Health Care Coverage Through Medicare: The Affordable Care Act will continue to provide protections and benefits to seniors who receive coverage through Medicare. Since the act was passed in 2010, Seniors have saved billions of dollars on the cost of prescription drugs, co-pays, and premiums. This upholding of reform also helps to save money and offer better care seniors on Medicare Advantage. However, the blow mentioned earlier to Medicare being offered to the nation’s poorest will have a negative effect on all Americans.

3. Individual Policy Holders: Obamacare health care reform requires all U.S. citizens to have healthcare insurance. Of course, if you already have private insurance, the healthcare reform will have little impact on you. Your rates may shift slightly, and your coverage will have added protections.

4. Uninsured Americans: The Supreme Court ruling means that most of the law set forth by Obama’s health care reform will remain unchanged. This means that all uninsured Americans will still have the option to buy health insurance through the state or federal exchanges. Those Americans who cannot afford coverage can get a federal subsidy. Of course, the law will offer the same protections to all Americans, including not being able to be turned away for preexisting conditions (effective 2014).

5. Small Business Owners: Due to their income bracket, small businesses have always been at a disadvantage when providing health insurance for their employees. While health care reform will not solve this problem, it does offer more options for employers wishing to provide coverage to their employees. It’s worth noting that ObamaCare does not tax businesses making under $250k, but does guarantee coverage to business owners and their employees.

Supreme Court ObamaCare: The Future of ObamaCare

The ObamaCare supreme court ruling has kept ObamaCare (mostly) intact for now. The law still stands, but time will be the test. If the Affordable Care Act goes to the supreme court again, the next ruling on ObamaCare could be it’s last.

Supreme Court Ruling Upholds Obama’s Health Care Reformobamacarefacts-footer

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of,, and other websites. He has been in the health insurance and healthcare information field since 2012. is a...

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