Commonly known as Obamacare, Romneycare, and now via Antonin Scalia, SCOTUS-care, the law faced its most recent challenge on the grounds the the IRS and the Obama administration violated their own law by providing subsidies to those who purchased health insurance in market exchanges set up the federal government.
The law explicitly restricts subsidies to those Americans who purchase insurance through "exchanges established by the states." The subsidies served as a financial incentive for the states to set up exchanges. Witness for the plaintiffs--Obamacare architect Jonathan Gruber.
Moreover, Senator Max Baucus, Democratic chairman of the Senate Judiciary Committee, who shepherded the PPACA through Congress, also affirmed that the bill restricted subsidies to exchanges set up by the states.
Because so many states refused to set up exchanges for their citizens to purchase insurance, the federal government set up its own. Then, in violation of its own law, the Obama administration began subsidizing the insurance premiums of those who purchased coverage in the federal exchange.
The court ruled, however, that "exchanges established by the states really means "exchanges established by the states and the federal government."
The Supreme Court justified their decision based upon the intent of Congress. According to John Roberts,
"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter."
Moreover, "Those credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid."
Roberts and his fellow justices completely misconstrued the intent of Congress. Of course Congress intended the insurance markets to work. The purpose of subsidies was to force the states to set up exchanges by means of the promise of federal dollars. The "calamitous" death spiral is what happens when the intention of Congress fails--something that no one anticipated. Contrary to everyone's expectation, many states refused to set up health insurance market exchanges. Once the Obama administration recognized what was happening, they intervened in violation of their own law. They set up their own exchanges and then subsidized the insurance premiums of those who purchased insurance in those federal exchanges.
Concluding the the majority of justices simply have decided to protect the PPACT at any cost, including the integrity of law itself, Antonin Scalia dubbed the law SCOTUS-care.