Affordable Care Act

5 Challenges Still Facing Obamacare

Jun 26, 2015

In its first five years, the Affordable Care Act has survived technical meltdowns, a presidential election, two Supreme Court challenges — including one resolved Thursday — and dozens of repeal efforts in Congress. But its long-term future still isn't ensured.

Here are five of the biggest hurdles that remain.

Medicaid Expansion

Ryan E. Poppe

A Supreme Court decision that upholds portions of the Affordable Care Act has over 800 thousand Texans breathing a sigh of relief.   But the ruling also has conservative groups crying foul, stating that the Court has reinterpreted its role in government.

Updated at 1 p.m. ET

The U.S. Supreme Court on Thursday handed the Obama administration a major victory on health care, ruling 6-3 that nationwide subsidies called for in the Affordable Care Act are legal.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," the court's majority said in the opinion, which was written by Chief Justice John Roberts. But they acknowledged that "petitioners' arguments about the plain meaning ... are strong."

A U.S. Supreme Court ruling expected as early as Monday morning  could result in hundreds of thousands of Texans losing their health insurance. 

The reason is the King v. Burwell case Justices on the court are poised to decide. 

Plaintiffs in the case have argued that subsidies which help lower-income people pay for insurance premiums under the Affordable Care Act should only be available in states that operate their own insurance markets. 

Texas is among 34 states that chose to have its residents use the federal government’s exchange rather than set up its own.

Online health insurance marketplaces are central parts of the Affordable Care Act. And, the federally run exchange, is where 27-year-old Kathryn Ryan, a restaurant server in Philadelphia, turned for health coverage, as soon as the law took effect.

"I was excited because if it weren't for Obamacare, I wouldn't be insured at all," she says. "I wouldn't have the ability to go to the doctor."

She can afford health insurance thanks to a $200 a month subsidy that brings her premium down to $60 a month.