The 7-2 ruling authored by liberal Justice Stephen Breyer did not decide broader legal questions raised in the case about whether a key provision in the law, which is formally called the Affordable Care Act (ACA), was unconstitutional and, if so, whether the rest of the statute should be struck down.
Even though the justices did not rules on the central arguments made, this is the third time the Supreme Court has upheld the health care law against legal challenges.
The Supreme Court kept the Affordable Care Act alive Thursday, ruling in a 7-2 decision that Texas and 17 other states - plus two individuals - lacked standing to challenge its constitutionality.
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"The Court holds that the plaintiffs do not have standing (a legal right to sue) to challenge the individual mandate because they have not shown a past or future injury fairly traceable to the defendants' conduct", Thursday's ruling reads. President Joe Biden has vowed to build on and expand the health care program enacted while he was Obama's vice president.
The provision, called the "individual mandate", required Americans to obtain health insurance or pay a financial penalty.
After Texas and other states sued, a coalition of 20 states including Democratic-governed California and NY and the Democratic-controlled House of Representatives intervened in the case to try to preserve Obamacare after Trump refused to defend the law.
The ruling keeps health care in place for millions of Americans, including the more than 3.5 million people who signed up for insurance provided through the Affordable Care Act during a special enrollment period earlier this year. Justices Samuel Alito and Neil Gorsuch were the only members of the nine-person court who dissented. "Fans of judicial inventiveness will applaud once again". The Supreme Court in 2012 and 2015 also fended off previous Republican challenges to Obamacare. "It is a victory for more than 130 million Americans with pre-existing conditions and millions more who were in immediate danger of losing their health care in the midst of a once-in-a-century pandemic". Obamacare expanded the Medicaid state-federal healthcare program and created marketplaces for private insurance.
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"Thanks to the tireless advocacy of Americans across the country and the work of Democrats in Congress, the Affordable Care Act endures", said Nancy Pelosi, the Democratic speaker of the House of Representatives.
The closest Republicans got was in the summer of 2017, when they controlled both the House and the Senate and had President Donald Trump in the White House.
Opposition to Obamacare seems to have receded as a political issue for Republicans as the party has emphasized other matters such as immigration, voting restrictions and hot-button cultural issues.
The Supreme Court previously upheld Obamacare by deeming the financial penalty under the individual mandate a tax permissible under the Constitution's language empowering Congress to levy taxes.
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Today's Supreme Court decision makes clear that the entirety of the ACA is lawful and continues to stand.