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 On Thursday, the high court upheld a central part of the
Affordable Care Act, as it is formally known. It was the second time
the court confirmed the legality of President Barack Obama's biggest
domestic achievement.
That greatly reduces the chances of any substantive legislative or
legal challenge to the law by Republicans until a new president
takes office in January 2017 after Democrat Obama leaves office.
By then, the law will have been on the books for seven years and
millions of Americans will have a stake in it, making it even more
difficult to dismantle.
"It is entrenched. There certainly will be no legislation (signed
into law) that will change anything for the next year and a half,"
said Joseph Antos, an expert in health policy at the American
Enterprise Institute, a conservative think tank.
"This administration is done with health policy. Everybody's done,"
Antos said.
 Obamacare survived a major legal test when the Supreme Court upheld
tax subsidies at the heart of the law that help millions of
Americans afford premiums they pay for health insurance.
Enacted in 2010, the law was meant to provide health insurance
coverage for millions of Americans who neither had insurance through
an employer nor could afford an individual plan. Republicans opposed
the law from the start, calling it unnecessary government
interference and "socialized medicine."
More than 10 million people now have insurance purchased through
state and federal marketplaces set up under the law. About 8.7
million of them get subsidies, the government says.
REPUBLICAN DISAPPOINTMENT, DEMOCRATIC VICTORY
Following Thursday's 6-3 court ruling, Republicans quickly vowed to
make the 2016 election campaign a referendum on Obamacare,
expressing disappointment with the court's decision.
Democrats cheered it, however. On the presidential campaign trail,
Democratic Party front runner Hillary Clinton expressed delight via
Twitter. "Yes! SCOTUS affirms what we know is true in our hearts &
under the law: Health insurance should be affordable & available to
all," she said.
Republican House Speaker John Boehner said, "We will continue our
efforts to repeal the law and replace it."
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But it was unclear what Republicans could do to make good on that
pledge. Republican lawmakers had worked on action plans for a high
court ruling against the subsidies, but there seemed to be no clear
Republican strategy for the ruling that was handed down, a
resounding victory for Obama.
The Republican party is divided, said Robert Blendon, a health
policy and politics analyst at Harvard University.
One wing "wants to go back to 2009" before Obamacare existed. Others
have proposed alternatives. Senate Finance Committee Chairman Orrin
Hatch, for instance, is urging the approval of tax credits to help
people buy insurance.
Some Republicans "feel they dodged a bullet" with the court's
decision, which means they won't have to anger their base by
preserving the subsidies, even temporarily, said John Ullyot, a
Republican strategist and former longtime Senate aide.
Most of the dozen or so Republican candidates running for their
party's nomination vowed to repeal Obamacare if elected.
Former Florida Governor Jeb Bush's campaign issued a fundraising
appeal for "emergency" contributions to ensure the law is rolled
back. "I will work with Congress to repeal and replace this flawed
law," Bush said in a statement.
Senator Marco Rubio, another Republican contender, said: “I remain
committed to repealing this bad law."
Brookings Institution analyst Stuart Butler said the law may be
modified, but it is now hard to imagine it being totally repealed,
even after a new president takes office in 2017.
"The longer it is on the books the harder it will be to dislodge,"
he said. "Not harder - impossible."
(Additional reporting by Emily Stephenson; Editing by Kevin
Drawbaugh and Grant McCool)
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