What was the effect of the Supreme Court ruling in 2015 on the ACA?

The Supreme Court ruling in 2015, specifically in the case of King v. Burwell, had a significant impact on the Affordable Care Act (ACA) by upholding the legality of subsidies provided in federally established marketplaces. The decision confirmed that individuals purchasing health insurance in states that did not create their own exchanges could still receive financial assistance in the form of tax credits. This ruling was critical in ensuring that millions of Americans could afford health insurance, thereby maintaining the access and affordability goals of the ACA.

The ability to receive subsidies in federally operated exchanges ensured that the health insurance markets would remain stable and accessible, as it prevented a situation where individuals in those states could be priced out of the market due to lack of financial assistance. The ruling reinforced the ACA's intent to facilitate affordable coverage, which was crucial for the continued expansion of health insurance under the law.