Affordable Care Act

Updated at 1 p.m. ET

The U.S. Supreme Court on Thursday handed the Obama administration a major victory on health care, ruling 6-3 that nationwide subsidies called for in the Affordable Care Act are legal.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," the court's majority said in the opinion, which was written by Chief Justice John Roberts. But they acknowledged that "petitioners' arguments about the plain meaning ... are strong."

Jennifer Pahlka at the 2014 Code For America Summit
Flickr Photo/Carlos Moreno

In 2013, the rollout of the Affordable Care Act on the website became a debacle for the Obama administration. Sen. Mitch McConnell said about it: "God only knows how much money they've spent and it's a failure … the government simply isn't going to be able to get this job done correctly."

The Affordable Care Act requires all Americans to get health insurance or pay a penalty. To help coax people to buy a health plan, the federal government now subsidizes premiums for millions of Americans.

This tax season, for the first time since the Affordable Care Act passed five years ago, consumers are facing its financial consequences.

Whether they owe a penalty for not having health insurance, or have to figure out whether they need to pay back part of the subsidy they received to offset the cost of monthly insurance premiums, many people have to contend with new tax forms and calculations.

Oregon's troubled health insurance exchange is one step closer to being dismantled.

The Obama administration often touts the health benefits women have gained under the Affordable Care Act, including the option to sign up for coverage outside of open enrollment periods if they're "having a baby."

Since the Affordable Care Act was signed into law in 2010, "repeal and replace" has been the rallying cry for Republicans who opposed it. But now that most of the law's provisions have taken effect, some health experts are pitching ways to tweak it, rather than eliminate it.

An ideologically diverse panel at the National Health Policy Conference on Monday presented different ideas to make the law work better. But the panelists agreed on one thing: The Affordable Care Act is too complicated.

The taxman cometh, and tax preparers are anxiously getting ready to deal with new rules that have kicked in because of the Affordable Care Act.

Under the Affordable Care Act, there are new forms, along with new questions for people who have – and don’t have – health insurance.

Flickr Photo/Greg McMullin (CC-BY-NC-ND)

Ross Reynolds interviews journalist and author Steven Brill about his new book, "America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Health Care System."

While finishing the book Brill had his chest sawed open for emergency heart surgery. A dream he had the night before the operation revealed a truth about the health care system. 

Flickr Photo/Alex Proimos (CC-BY-NC-ND)

For the past two years primary care doctors who saw Medicaid patients were given a pay increase. The extra money was an incentive for doctors to take in new patients who became eligible under Medicaid expansion. But starting January 1, 2015, that pay increase expires. Marcie Sillman talks to KUOW’s healthcare reporter Ruby de Luna about how this change might impact Medicaid patients.

This time last year, federal officials were scrambling to get as many people enrolled in health insurance through as they could before the start of the program on Jan. 1.

Now, with the technical problems mostly fixed, they're facing a different problem: the possibility that the Supreme Court might rule that the subsidies that help people afford coverage are illegal in the 37 states where the federal government is running the program.

Marcie Sillman interviews KUOW health reporter Ruby de Luna about some of the changes the Washington state Health Exchange has made. Last year more than a million Washington state residents signed up for health insurance through the Washington Health Plan Finder website.  Saturday is the first day of open enrollment. People need to sign up or renew their health care plans by February 15, 2015. 

Exactly one year ago, the Obamacare insurance exchanges stumbled into existence. Consumers struggled to sign up for its online marketplace — and the Obama administration was pummeled. Eventually,'s problems were mostly fixed, and two weeks ago, the administration announced 7.3 million people have bought insurance through it so far this year.

So, was the health exchanges' first year a success — or something less?

Ask President Obama, and he says you measure the Affordable Care Act's success this way:

Mobile Medical
KUOW Photo/Kara McDermott

About twice a month, King County’s Mobile Medical van comes to Renton. It opens at 4:30, but it’s often slow until closer to 6:30, when the church across the street begins serving hot meals for homeless people.

The inside of this RV has been retrofitted so there’s an exam room, a nurse’s station and a waiting area.  A generator gives off a droning buzz as it powers this efficient little clinic.

The leaders of Oregon's struggling health insurance exchange will be grilled by state lawmakers in a series of hearings at the capitol on Monday and Tuesday.