In Cal­i­for­nia, not much. The con­tin­ued allowance of the sub­si­dies for those mem­bers in the Fed­er­al Exchange cer­tain­ly solid­i­fies the posi­tion of the Exchanges and thus, indi­rect­ly, the Cal­i­for­nia Exchange. The prob­lem in Cal­i­for­nia is what­ev­er the prob­lems are in Cal­i­for­nia, which at this time is the fact that they may not be able to meet their finan­cial com­mit­ments. So Cal­i­for­nia could go the way of fed­er­al Exchanges, which have just been val­i­dat­ed. Good news?

What the deci­sion does mean, of course, is that the Supreme Court has rebuffed the sec­ond chal­lenge to the legal­i­ty of the Afford­able Care Act – which is now here to stay…at least until the next elec­tion. The media fall­out includ­ed com­ments such as:

Judge Scalia said “Roberts per­formed som­er­saults of statu­to­ry inter­pre­ta­tion to save the act” and the deci­sion was “inter­pre­tive jig­gery-pok­ery” and “pure apple­sauce” and added that words

“no longer have mean­ing if an Exchange that is not estab­lished by a State is estab­lished by a State” and, final­ly, that those jus­tices who vot­ed to retain the ACA did it for polit­i­cal reasons.

On NBC, Chuck Todd said “you saw Repub­li­can pres­i­den­tial can­di­dates from Jeb Bush to Mar­co Rubio and in par­tic­u­lar Ted Cruz all pledg­ing to say that if elect­ed, that this pres­i­den­tial elec­tion is now about the last chance you have to stop Oba­macare or to repeal Obamacare”

Sen­a­tor Lind­sey Gra­ham said the rul­ing “only rein­forces why we need a Pres­i­dent who will bring about real reform that repeals Oba­macare and replaces it with a plan that expands con­sumer choice, increas­es cov­er­age, deliv­ers bet­ter val­ue for the dol­lar and gives states more con­trol with­out sti­fling job creation”

House Speak­er John Boehn­er said “we will con­tin­ue our efforts to repeal the law and replace it with patient cen­tered solu­tions that meet the needs of seniors, small busi­ness own­ers and mid­dle class families”

How­ev­er, accord­ing to ABC’s Jon Karl “Pub­licly, Repub­li­cans are express­ing out­rage over this rul­ing, but pri­vate­ly, many Repub­li­can lead­ers are breath­ing a sigh of relief, because if this rul­ing had gone the oth­er way, more than 6 mil­lion Amer­i­cans, most of them from states with Repub­li­can gov­er­nors, would have lost their health­care sub­si­dies, and Repub­li­cans were deeply divid­ed about what to do about it” – a sen­ti­ment echoed by a reporter from the Wash­ing­ton Post