Republican presidential candidate, Sen. Rand Paul of Kentucky, told Wolf Blitzer on CNN that in the June 25 Supreme Court decision in King v. Burwell that the justices had "missed an opportunity" to let Congress to decide on the fate of those parts of the Affordable Care Act (Obamacare) that he finds objectionable.
In the interview, Paul said “As a physician, the Supreme Court missed an opportunity here. Obamacare is making all insurance more expensive. I think we made a mistake. If they would have ruled and adhered to the literal nature of the law, maybe Congress would have had a chance to take up Obamacare again and try to make it less bad or fix the parts of it that are causing so many problems in our society. I really think Obamacare is making all insurance more expensive and taking away choice. So I am disappointed that we’ve missed an opportunity here.” The Supreme Court ruling affirms the Federal government’s power to subsidize health-insurance purchases by Americans in low-income brackets. 
However, medical insurance companies and health providers appeared to greet the news of the Supreme Court decision with optimism. Stocks for the two segments were spiking upwards on June 25. For example, hospital operators Tenet Healthcare Corp.THC +12.24%, Universal Health Services Inc.UHS +7.73% , Community Health Systems CYH +12.97%, Inc., and HCA Holdings HCA +8.82%, Inc., all registered gains of more than 8% in the moments after the news.  Centene Corp.CNC +3.88%, Molina Healthcare, Inc., and WellCare Health Plans, Inc., all of which are Medicaid insurance providers, went up between 2% and 4%.
Senator Paul is apparently still hoping for reform to ACA, in order to “give patients back more choices on whether they can choose which doctor or which insurance plan, legalize competition and legalize inexpensive insurance again, but it makes it hard because we don’t have the leverage. If we had the leverage where the president had to revisit this because part of it had been struck down, then we would have the leverage to force the president to revisit it. We have majorities and so we can bring it up and we can pass legislation, but getting the president to actually do something about it and actually have the leverage to get him to perhaps sign something that would change Obamacare, I think we’ve lost that leverage.”
Supreme Court Chief Justice John Roberts led the majority on the bench in the victory for President Barack Obama. Peter Suderman of Reason Magazine wrote, “Roberts has not merely tweaked the law; he has rewritten it to mean the opposite of what it clearly means. Why include the phrase "established by a State under Section 1311"—the section dealing with state-based exchanges—except to limit the subsidies to those particular exchanges?” Moreover, wrote Suderman, “Roberts’ majority opinion today in King v. Burwell, which ruled that the Obama administration’s decision to allow health insurance subsidies flow through the law’s federal exchanges, leaves no doubt that Roberts considers it his duty to keep the law afloat.”
Roberts wrote in the majority opinion, "Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," adding, "If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter."
Furthermore, said Suderman, “And so Roberts decided that a law which explicitly and repeatedly states that subsidies are limited to exchanges "established by a State," and which defines "State" as one of the 50 states or the District of Columbia, actually allows subsidies in exchanges established by a State or the federal government. Roberts’ decision does not interpret Obamacare; it adds to it and reworks it, and in the process transforms it into something that it is not.”
Justice Antonin Scalia, for his part, wrote a scathing dissent, saying that Roberts presumes without definitive evidence that his own interpretation of ACA concords with Congressional intent. "What makes the Court so sure that Congress ‘meant’ tax credits to be available everywhere?" Scalia asked. "Our only evidence of what Congress meant comes from the terms of the law, and those terms show beyond all question that tax credits are available only on state Exchanges."
"The Court protests that without the tax credits, the number of people covered by the individual mandate shrinks,” said Scalia, “and without a broadly applicable individual mandate the guaranteed-issue and community-rating requirements ‘would destabilize the individual insurance market.’ If true, these projections would show only that the statutory scheme contains a flaw; they would not show that the statute means the opposite of what it says."  Apparently arguing that the Supreme Court has thus seized power from the legislative branch, Scalia seethed,  "the Court’s insistence on making a choice that should be made by Congress both aggrandizes judicial power and encourages congressional lassitude."
Suderman opined, “This is not judicial restraint. It is judicial hubris.”
As for Scalia, he wrote in a coda to his dissent,  "we should start calling this law SCOTUScare." 



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Spero News writer Martin Barillas is a former US diplomat, who also worked as a democracy advocate and election observer in Latin America. His first novel 'Shaken Earth', is available at Amazon.

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