--- title: Obamacare: 4 Ways the Supreme Court Could Rule on Health Care description: The health care law is once again before the high court canonical: https://time.com/3731961/obamacare-supreme-court/ author: TIME article:opinion: false article:content_tier: free article:published_time: 2015-03-04T18:39:06.000Z article:modified_time: 2026-08-04T07:40:54.558Z article:section: Politics og:title: 4 Ways the Supreme Court Could Rule on Obamacare og:description: The law's supporters would only like two of them. og:url: https://time.com/3731961/obamacare-supreme-court/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt1bc04d657a023a72/6987820cf887dca658e8a6da/supreme-court-health-care-protest.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2560 og:image:height: 1440 og:image:alt: Supporters of the Affordable Care Act gather in front of the U.S Supreme Court during a rally in Washington on March 4, 2015. og:type: article twitter:card: summary_large_image twitter:title: 4 Ways the Supreme Court Could Rule on Obamacare twitter:description: The law's supporters would only like two of them. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt1bc04d657a023a72/6987820cf887dca658e8a6da/supreme-court-health-care-protest.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # 4 Ways the Supreme Court Could Rule on Obamacare > Sponsored content. 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Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-network-2026q3/newsletters?i=f94467e5-863f-46a8-8c1d-e0520d35b3c7&cr=time-nl-network-2026q3-v1) ## Video: How Health Care Is Changing for 2015 [Watch (HLS stream): How Health Care Is Changing for 2015](https://cdn.jwplayer.com/manifests/asBSrQOp.m3u8) (1:23)  _Published 2014-12-17. A focus on preventive care, wellness programs, and insurance updates are the main health care changes coming to employer-sponsored programs in 2015._ by [Ryan Teague Beckwith](https://time.com/author/ryan-teague-beckwith/) ## Ryan Teague Beckwith Mar 4, 2015 6:39 PM UTC  Supporters of the Affordable Care Act gather in front of the U.S Supreme Court during a rally in Washington on March 4, 2015. Supporters of the Affordable Care Act gather in front of the U.S Supreme Court during a rally in Washington on March 4, 2015. Alex Wong—Getty Images by [Ryan Teague Beckwith](https://time.com/author/ryan-teague-beckwith/) ## Ryan Teague Beckwith Mar 4, 2015 6:39 PM UTC When the Supreme Court last considered the Affordable Care Act, the argument was easy to follow: Does the federal government have the power to force people to buy health insurance? The question this time is a lot more complicated. As the justices discussed a single line in the law Wednesday, they were debating issues of administrative law precedent, congressional intent and interpretation of statutory language. But the bottom line is still the same. If the court’s majority rules a certain way, the law would collapse, causing as many as [eight million people to lose their health insurance](http://time.com/3730936/supreme-court-obamacare/). The case centers on whether states need to set up their own health insurance exchanges under the law for their residents to qualify for subsidies that make it affordable. Here’s a quick look at four ways the court could rule. **The Liberal Hail Mary** **The ruling:** The majority finds that the people bringing the lawsuit don’t have the standing to sue and throws out the case without ruling on the merits. **The argument:** One plaintiff [listed her address](http://www.wsj.com/articles/new-questions-swirl-on-an-affordable-care-act-challenger-1423527427?tesla=y) as a motel. The others might qualify for [veterans health care](http://www.wsj.com/articles/health-law-challengers-standing-in-supreme-court-case-is-questioned-1423264458) or [Medicare](http://www.motherjones.com/politics/2015/02/king-burwell-supreme-court-obamacare), which would make their claims of being hurt by the law a moot point. **Why they would do it:** Chief Justice John Roberts might agree with the liberal justices as a face-saving way to make the case go away. He was quiet during oral arguments Wednesday. **Why they wouldn’t do it:** Even if three of the four plaintiffs don’t have standing, if the fourth did, the case could move forward. It’s a longshot. **The Ironic Precedent** **The ruling:** The majority finds that forcing states to create their own health insurance exchanges at the risk of their residents losing subsidies is [improper coercion](http://www.wsj.com/articles/as-supreme-court-weighs-subsidies-health-law-opponents-face-hurdle-1425256395). **The argument:** Without the subsidies, a state’s health insurance market would fall into a “death spiral.” That means the law would effectively force states to build one. **Why they would do it:** In its last decision, the court overturned a part of the law forcing states to expand Medicaid, saying it was coercive. Justice Anthony Kennedy seemed open to that logic again. **Why they wouldn’t do it:** It’s a constitutional argument, which is a bigger deal than for the justices to simply interpret the law’s wording. **The ‘Not Our Problem’** **The ruling:** The majority finds that the law is poorly written but needs to be interpreted strictly, essentially saying the court’s hands are tied. **The argument:** Congress didn’t do its job well when it passed the final version of the bill, but it’s not up to the White House — or the court, for that matter — to fix it. **Why they would do it:** The Supreme Court regularly throws laws back to Congress to fix. They’ve done it recently it with [a fair pay law](http://content.time.com/time/nation/article/0,8599,1874954,00.html), the [Voting Rights Act](http://swampland.time.com/2013/06/25/high-court-rolls-back-the-voting-rights-act-of-1965/) and [campaign finance law](http://time.com/46738/supreme-court-mccutcheon-campaign-finance-law/). **Why they wouldn’t do it:** Precedent. In the [most-cited administrative law case in history](http://ir.lawnet.fordham.edu/cgi/viewcontent.cgi?article=5037&context=flr), the Supreme Court found that the White House should have leeway to interpret poorly worded laws. ### See Ruth Bader Ginsburg Grow from Toddler to Supreme Court Justice  August 2, 1935 Childhood photograph of Ruth Bader taken when she was two years old. Collection of the Supreme Court of the United States  1948 Ruth Bader delivers a sermon as camp Rabbi at the age of 15, at Che-Na-Wah camp in Minerva, N.Y. Collection of the Supreme Court of the United States  December, 1953 Studio photograph of Ruth Bader, taken in Dec. 1953 when she was a Senior at Cornell University. Collection of the Supreme Court of the United States  Fall, 1954 Martin D. Ginsburg and Ruth Bader Ginsburg taken in the fall while Martin Ginsburg served in the Army, before being drafted, stationed at Artillery Village in Fort Sill, Okla. Martin Ginsburg was drafted into the Army in 1954. Collection of the Supreme Court of the United States  Summer 1958 Ruth Bader Ginsburg and Martin Ginsburg play with their three-year old daughter, Jane, in her bedroom at Martin's parents' home in Rockville Centre, N.Y Collection of the Supreme Court of the United States  Fall 1980 Judge Ruth Bader Ginsburg during her first term as a United States Circuit Judge to the U.S. Court of Appeals for the District of Columbia. Collection of the Supreme Court of the United States  December, 1980 Ruth Bader Ginsburg, her husband Martin Ginsburg, and their children James and Jane in a boat off the shore of St. Thomas in the Virgin Islands. Collection of the Supreme Court of the United States  1972 Ruth Bader Ginsburg with her husband Martin at the Greenbrier resort in White Sulphur Springs, W.V. Collection of the Supreme Court of the United States  Oct. 1, 1993 Informal portrait of Justice Ruth Bader Ginsburg standing before the mantle in the Justices' Dining Room in Washington. Collection of the Supreme Court of the United States  August 10, 1993 Justice Ruth Bader Ginsburg is sworn in as an Associate Justice of the Supreme Court. From left to right stand President Bill Clinton, Justice Ruth Bader Ginsburg, Martin Ginsburg, and Chief Justice William Rehnquist. Collection of the Supreme Court of the United States  Official portrait of Justice Ruth Bader Ginsburg Steve Petteway—Collection of the Supreme Court of the United States **The Conservative Hail Mary** **The ruling:** The majority finds that Congress intended for a state’s residents to be denied subsidies if the state didn’t set up its own insurance exchange. **The argument:** An MIT economist who helped design the law [once said that](http://www.huffingtonpost.com/2015/03/02/obamacare-supreme-court%5Fn%5F6783894.html) in an academic lecture that has since gone viral in conservative circles. **Why they would do it:** The lawsuit’s supporters have argued that Democrats in Congress intended this all along. Going along with that argument would avoid the problem of legal precedent. **Why they wouldn’t do it:** There’s lots of evidence, such as [interviews with the staffers who actually wrote the law](http://www.vox.com/2014/7/23/5927169/halbig-says-congress-meant-to-limit-subsidies-congress-disagrees), that Congress didn’t intend this. It’s a longshot. ## Transcript Employers are on sort of a long term trend of trying to shift more of the costs to their employees, to the people receiving the care. And it's an effort to sort of make health care more efficient. [ MUSIC ] They are sort of divvying up, or differentiating where you get your care. When it comes to something like Telemedicine. Which is where you sort of take a picture of something that's wrong with you and like, or you're curious about. Like a rash or something like that. And send that to your doctor, that's about half the price of going to your primary care doctor. So, it can be cheaper for them, and for you. It's all about being proactive with your health care and sort of knowing. What's going on with your, with your health and how best to, how best to treat whatever it is that needs to be treated. This means you need to sort of be in charge of your health care. You need to know where to go when something happens. It really depends on you. I mean like, if you do not take advantage of the wellness programs, your costs may go up. You can lower your bill and your overall health care spending, and be, if you're a little bit more correct. It, but at the same time, it requires a lot more attention. It requires a lot more work on your part. 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