its i'm antonio mora thanks for joining us. for more news head to aljazeera.com. ray suarez is up next with "inside story". [ ♪♪ ] the dagger - pointed at the throat of the affordable care act has been pulled away. the case king verse burwell had been decided by the supreme court and the justices announced that the law stands. now what. will states that held back buy in or is one battle ends does another begin. is the fight over obama care really over?

it's tonight's "inside story". >> reporter: this morning the court upheld a critical part of this law. the part that's made it easier for americans to afford health insurance, regardless where you live. >> welcome to "inside story", i'm ray suarez. at its simplest the ruling by a majority of justices will allow people in states that did not set up health care exchanges under the affordable care act to take advantage of subsidies for buying health insurance. if the justices voted the other way, a glitch in the plain language of the law would have allowed subsidies in those states that operated their own exchanges, a minority as it happens. as al jazeera's lisa stark

explains obama care dodged a bullet. >> reporter: supporters of the health care law gathered outside the court. when the ruling came down... ..they let out a cheer. and began to celebrate. [ chants ] >> reporter: the 6-3 decision means government subsidies that help low and moderate income americans pay for health insurance will continue to be available nationwide, not just in the states that set up their own health care exchanges. supporters were jubilant. >> make no mistake about this. today's decision has monumental significance. it means that the affordable care act is not just the law of the land it will remain the law of the land. it moons that the millions of people who have been receiving subsidies that make all the difference in terms of whether

health insurance is affordable. people will continue to receive the subsidies, and will continue to have health insurance. >> if the court had known the other way, 6.4 million people in 34 states who buy their insurance through the federal web site would have lost their tax credits, their subsidies, making health insurance unaffordable. at issue before the court, four words in the affordable care act that reads - tax credits are available for those that enroll in health care through: chief justice john roberts writing for the majority said the words must be taken in context: roberts said: lip looup

justice scol era announced his dissent. saying: the group behind the challenge wasn't disappointed. >> today's ruling was a tragedy for the rule of law. the supreme court twisted and summer assaulted on rules of statutory interpretation. this is the second time in three years that the supreme court has upheld a key provision of the aca.

this time more definitively. other legal challenges are winding through the lower courts much after the ruling the aca, for now. is on firm legal ground. joining us for a further look at the supreme court's decision in king versus burwell is fab reetso. an attorney who writes about the supreme court. welcome to the programme. it's a pleasure to be here. at the core of chief justice john roberts decision was a very, very conscious - he was very conscious of the consequences of this decision. is that really what tilted the scales in the favour of the affordable care act? >> i think what chief justice roberts said in this opinion was that this - he was obligated and felt the necessity to read the

language of the statute in the context of the statue which was to say to look at the words, the purpose of the statute, and the larger historical problem that the congress was trying to involve. he interpreted the language in light of all of that understanding. and that drove him to an interpretation that made the statute workable. >> in the scalia dissent, does he have a point - associate justice scalia when he says basically they have taken words that have obvious plain meaning and construed them to mean something else entirely. >> i think what you are seeing here is a contest between two competing views of how to understand statutory language. yes, justice scalia has a point that the plain language of the statute can be taken to mean what he says it moons.

-- means. on the other hand what the chief justice argued and the majority held is those words were sufficient because they provided sufficient ambiguity, and there was an important impulse to interpret that ambiguity in favour of making the statute work because that was an important democratic principle. >> you are a court watcher, is it significant that the chief justice wrote the opinion for the majority is this. >> i think it is. generally speaking when the chief speaks for the court, it is of note. he is often referred to as a first among equals, and i think it is of note that he was the author of the constitutional challenge to the care affordable care act in to 12. >> and when we look not at a 5-4, but a 6-3 decision, is that

significant, that it didn't pass by the slimmest of marge jips but had a little room to spare? >> i think so. on the other hand i would say oftentimes the ruling is when you get to five, five matters. it's reading the court that it was scalia writing for justice scol eido and justice thomas the more conservatives of the justices, and the six on the other side are generally viewed as luberral and less conservative. but it's a vote to affirm is a vote to affirm. >> the last decision was very closely watched as well. and had to do with taxation and the powers of different parts of the government. is this actually a ruling of such significance, we heard a consumer advocate call it

monumental, that we can look at the affordable care act as home and tried. really safe for a while. >> there are challenges that will come up for example, there are questions about how religious freedom ret relates to the care in 2012 there was a constitutional challenge to the affordable care act, which did not stand. again an opinion authored by the chief justice, and this last one that has the potential to undo a core way of making it health care accessible to a significant number of people. that challenge was turned back as well. what will probably happen going forward is there may be incremental challenges, but

nothing at least as i can see it, that will strike at the core of what the statute is like. >> nibbling around the edges, not able to tackle the eddy fizz of the care your. >> i don't think so. from everything that is coming out, the core of this statute is safe. at some level it establishes an important piece of president obama's legacy. there may be some changes going down the road. whether that's by court challenge, but the core idea seems to be in place fairly steadily. >> blogs on the supreme court for governingworks.org. great to have you with us. people on all side of the struggle dimest the opinion, does the road ahead for the affordable care act change. will more states join the exchanges, will the uninsured

who have not bought insurance be waiting at the window the next time enrolment begins what will it mean for combatants the customers, opponents, administration and insurance companies, is the fight over affordable care act over. it's "inside story".

you're watching "inside story", i'm ray suarez now that this phase in the fight against affordable care act is over does anything change will governors who held their states out of the exchanges, didn't accept the subsidies, worked against the law relent or does the fight enter another phase? joining me from new york. the deputy director of the center for medical progress at

the manhattan institute. and wental potter senior analyst. a former executive at saying na and author of "obama care what's in it for me." let me start with you. at lunch time the president spoke from the white house, basically saying obama care is here to say. is he rite? >> i don't think obama care will be repealed soon. in that sense, absolutely. that said it's a little early to start cheering. there's a lot of problems with the law, the changes are going to face problems in the coming years. the opportunity is right. >> as a practical matter of state craft, once a law survives the scrutiny do opponents and supporters fill in around it and maybe fix the problems with the law, instead of trying to pull it down altogether?

>> i think we have seen support building pore changes to the law. polls show that people are predominantly not positive towards a law. they don't love it they don't hate it. they want to see challenges but not repealed. this is the latest in a string of decisions, a string of changes in how people view the law that does represent the shift towards not necessarily loving it but accepting it as part of the american welfare state. >> wendell potter you heard fab ritsio talk about religious freedom changes, are there threats looming out there that may change the way the law is applied? >> you know i don't think there are serious threats that will change it significantly. i think that you will see that the changes will bring more

people into coverage i think you'll see more governors and legislators looking at medicaid expansion, and i think you'll see more of the state's expanding the coverage, it makes economic sense to do that. there'll be pressure from the hospitals, for example in the states that have not expanded programs to do that because they can generate more revenue from the government. if they do and there'll be fewer uninsured people showing up in the emergency rooms. so you'll see, i think, considerable pressure continuing and intensifying in the states. >> when that happens, when a law that's been the subject of controversy, when the combatants put down their weapons, does it take on a momentum that it didn't have before. does it harden institutionally and does that make it really harder to mess with down the

road? >> i think it makes it harder to mess with down the road. it is becoming more of the fabric of the way things are. now that we are five years in to this being a law of the land and more certainty that it will continue. it will be harder. >> it will be harder to sustain the opposition from a political point of view. it will still - we'll hear criticism of it. i think after that it will diminish. it being the criticism of obama care. and that's because i don't think the candidates are able to articulate in a meaningful way what they'd do to replace obama care if they were pressed to do that. >> i want to talk more about what is available to the g.o.p. later in the programme. but earlier you mentioned there

are still, in your view serious problems with the law. what should be fixed, what should be job one for people that say we have to live with it let's fix it? >> so i thick there are two things that you start off with. number one you get rid of mandate. this is something the economists on the left and the right agreed is a terrible part of the law. it doubles down on the failed insurance system that we had over the past 50 years or so. the second change is more contentious, it's expanding how insurers are allowed to charge people. we are not seeing the share of young people enrolling from the first year. that could change in the third year. but if we think it will not change making insurance cheaper for them and more expensive for the older enrollees would pull in some of the younger folks. that's a priority.

>> i know the employer candidate was controversial. wasn't it a device for getting people into the risk pools, and that was supposed to push the cost curve down. >> it's a little more complicated than that. the way that the risk pools work is that insurers separate their employer risk pools from market. they are treated separately and the effect of the employment the mandate on insurance is likely fairly minimal. the urban institute did research on this they said it's about 500,000. the c bo has their own estimates. it's low in the grand scheme of things. you could theoretically getrid of the employment mandate and see relatively similar coverage levels without the effect of the mandate. >> i'll be back with potter. republicans in congress and running for president will not have to find an alternative to

obama care and replace subsidies or reensure hundreds of thousands. it hardly means thl concede defeat or stop the effort to pull it down. is the fight over affordable care act over. it's "inside story". . >> the problem with obama care sill is fundamentally the same. the law is broken. it's raising costs for american families. it's raising costs for small businesses. and it's fundamentally broken.

welcome back to "inside story", i'm ray suarez we are acting if the fight over the affordable care act is over. tonight on the programme, after four years of relentless opposition scores of votes to repeal the law and encouragement for legal efforts to pull it

down republicans in washington and state houses around the country have decisions to make especially with a new presidential campaign heating up. what is the next move. wendell potter and yourself gepy are with us. wendell, you brought up politics earlier in the programme. the affordable care act was a big issue in the midterms in 2010 and 2014. in 2010 before the law had taken effect. can we expect the same the next time around? >> i think it will be an issue, i think probably not after 2016. i'm not sure it will be as much a factor in 2016 as it would have been otherwise. in fact, i'm certain it will not be. i think you'll see a diminishment of health care as a - as an issue that will be at the top of people's interests. i think people have some fatigue about health care and we have many other problems.

so i think you'll see people beginning to shift their attention elsewhere. that includes pol teshes tirps too -- politicians, too. >> do you agree? >> sort of. i think it will certain be less important than other factors like the economy. that being said i think there's still some things coming down the pipe that will piss people off potentially. there are opportunities for higher premium increases on the exchanges, the cadillac tax comes around in 2018. people will feel that and may not relate it to health care. if a candidate tells them there are these costs around the corner, and they are related to the eca and will hit your wallet. people will feel it and pay attention to it. >> earlier wendell potter said he believed some governors that had been staying out of the medicare enhancement may go into it because they are keeping

large numbers of their people uninsured and that part of the battle appears to be over. what do you think? >> there's a difference in insured rates between those that did and didn't expand medicaid programs. there are other differences, typically stating that they have not had low uninsured rates. there's more to the question. i'm not sure if really all governors that proposed it are going to be won over that quickly. i think that there'll still be an uphill battle and some states - you'll never get. others sweeten the deal. it will come down to how much the administration gives the state. how much leeway will be over. >> king versus burwell has been decided. if you look over your shoulder has opposition hampered

implementation of the law. would it be working better if there haven't had been so many people working against the implementation. >> there's no doubt that would have been the case. that diminishes well too. on the other handsome of the problems were self-inflicted with the changes that we started with the end of 2013 and 2014. it wasn't just the opposition. sometimes the democrats did not have it either and the democrats were running away from the affordable care act, when they conceded it wasn't as popular as they hoped it would be. a lot of blame for public opinion has to be laid at the feet of the administration. probably you will start seeing the democrats being a bit more bold for taking credit for the successes. some of the political dynamics

will change and the insurance industry is relieved here. they know. justice roberts' opinion or majority report noted that in the first paragraph, that had the dash if the decision went the other way, there would be chaotic health ipp shurps markets that -- insurance markets that did not operate. >> we only have about 30 seconds left. did the opposition hamper the implementation of the law? >> to some degree but i agree with wendel. a lot of the difficulties with the law were self-inflicted. the administration did their best to minimise what they saw as ill-effects on certain populations and insurance companies, and offered remedies that backfired. it obviously was instrumental in

turning people are gaips it if nothing else horror stories were easy to trot out. as we moved forward, people become a little more supportive. >> wendell potter is the author of obama care. what's in it for me. a senior analyst. deputy director of the center for medical progress. thank you both. in a moment a final word on health care as a consumer good. send your thoughts on twitter, or follow me and get in such at ray suarez. or visit the facebook page and tell us about your own experience. we'd love to hear about it. >>

we buy health insurance in a way we buy no other product. we buy half hoping not to use it, hope to pay as little as we can. reaping as much benefit as we can from a maze of hidden subsidies. unfortunately too many equate intensity of use with quality and expense with quality. be honest. if you had to find a surgeon on your own, would you call a

hospital and ask the switchboard, please connect me. how many of us can say to get a tent stent put in your heart, have carpal tunnel relieved or a week's worth of pain medicine. we as citizens entered the national debate over obama care wilfully ilinformed over how insurance works, how it paid for care and the relationship between what we pay as a deduction on a pay check every two weeks, versus what the care we presume would cost us if paid pocket. maybe the battle royale after the past five years, much was not about health care would get smarter, tougher, and more concerned with getting more americans covered. i'm ray suarez.

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