The court ruled on a 6-3 vote that the 2010 Affordable Care Act, widely known as Obamacare, did not restrict the subsidies to states that establish their own online healthcare exchanges. It marked the second time in three years that the High Court ruled against a major challenge to the law brought by conservatives seeking to gut it.
              
"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Roberts wrote in the court's decision, adding that nationwide availability of the credits is required to 'avoid the type of calamitous result that Congress plainly meant to avoid'.

Roberts was joined by fellow conservative Justice Anthony Kennedy and the court's four liberal members in the majority.
               
Shares of hospital operators, health services providers and insurers rallied broadly following the court's decision to uphold the subsidies. Top gainers included hospital companies Tenet Healthcare Corp, up 8.8 percent, and Community Health Systems Inc, up 8.5 percent.
               
The decision means the subsidies will remain not just in the 13 states that have set up their own exchanges and the three states that have state-federal hybrid exchanges, but also in the 34 states that use the exchange run by the federal government.
               
The case centred on the tax subsidies offered under the law, passed by Obama's fellow Democrats in Congress in 2010 over unified Republican opposition, that help low- and moderate-income people buy private health insurance. The exchanges are online marketplaces that allow consumers to shop among competing insurance plans.

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