'Obamacare' survives: U.S. Supreme Court dismisses big challenge

10, 2017, file photo, the Supreme Court in Washington is seen at sunset.

The Supreme Court, though increasingly conservative in makeup, rejected the latest major Republican-led effort to kill the national health care law known as "Obamacare" on Thursday, preserving insurance coverage for millions of Americans.

The justices, by a 7-2 vote, left the entire Affordable Care Act intact in ruling that Texas, other GOP-led states and two individuals had no right to bring their lawsuit in federal court.

The Biden administration says 31 million people have health insurance because of the law, which also survived two earlier challenges in the Supreme Court.

The law's major provisions include protections for people with existing health conditions, a range of no-cost preventive services, expansion of the Medicaid program that insures lower-income people and access to health insurance markets offering subsidized plans.

"The Affordable Care Act remains the law of the land," U.S.

Also left in place is the law's now-toothless requirement that people have health insurance or pay a penalty.

And with a Supreme Court that includes three appointees of former President Donald Trump, opponents of "Obamacare" hoped a majority of the justices would finally kill the law they have been fighting for more than a decade.

But the third major attack on the law at the Supreme Court ended the way the first two did, with a majority of the court rebuffing efforts to gut the law or get rid of it altogether.

Justice Stephen Breyer wrote for the court that the states and people who filed a federal lawsuit "have failed to show that they have standing to attack as unconstitutional the Act's minimum essential coverage provision.".

In dissent, Alito wrote, "Today's decision is the third installment in our epic Affordable Care Act trilogy, and it follows the same pattern as installments one and two.

In all three episodes, with the Affordable Care Act facing a serious threat, the Court has pulled off an improbable rescue." Alito was a dissenter in the two earlier cases in 2012 and 2015, as well.

Like Alito, Justice Clarence Thomas was in dissent in the two earlier cases, but he joined Thursday's majority, writing, "Although this Court has erred twice before in cases involving the Affordable Care Act, it does not err today.".

Because it dismissed the case for the plaintiff's lack of legal standing -- the ability to sue -- the court didn't actually rule on whether the individual mandate is unconstitutional now that there is no penalty for forgoing insurance.

Lower courts had struck down the mandate, in rulings that were wiped away by the Supreme Court decision.

With the latest ruling, the Supreme Court reaffirmed that "the Affordable Care Act is here to stay," former President Barack Obama said, adding his support to Biden's call to expand the law.

His giant COVID-19 relief bill significantly increased subsidies for private health plans offered through the ACA's insurance markets, while also dangling higher federal payments before the dozen states that have declined the law's Medicaid expansion

Most of the people with insurance because of the law have it through Medicaid expansion or the health insurance markets that offer subsidized private plans