In Halbig v Burwell, the D.C. Circuit Court of Appeals ruled that subsidies for health insurance premiums can only be provided to individuals buying insurance through their state-run health insurance exchange. Only 16 states and the District of Columbia set up their own health insurance exchanges.
Let’s start by clearing up some of the confusion surrounding the ACA, or Obamacare. What is commonly called “Obamacare,” is actually the Patient Protection and Affordable Care Act, or the ACA. It is not government healthcare. It is not free healthcare. It is health insurance reform. The ACA requires insurance companies to sell policies to people regardless of their medical history. In exchange, insurance companies spread out their risk of insuring people who might get sick and need to use their health insurance by requiring every American to purchase insurance (the individual mandate). The individual mandate protects the bottom line for insurance companies. It is why they agreed to drop the pre-existing condition and extend insurance policies to more people.
Why do we need healthcare reform? Because even after Obamacare, it is possible that an American can’t afford health insurance, and doesn’t qualify for Medicaid. https://www.healthcare.gov/where-can-i-get-free-or-low-cost-care/