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Five signs the fight over Obamacare isn't finished

The court ruled 6-3 that the government is permitted to give tax subsidies to people who sign up for health insurance on the federal exchanges 07:11

The Supreme Court rebuffed the latest (and likely last) judicial challenge to Obamacare on Thursday, ruling in a 6-3 decision that the law entitles Americans in all 50 states to health insurance subsidies.

Opponents of Obamacare were hoping that the Court would undermine one of the law's central components by ruling that insurance tax credits were available only to consumers in the 14 states that set up their own insurance marketplaces - not those in the 36 states that used the federal marketplace.

Obama on health care ruling: “This law is here to stay” 07:42

That didn't pan out, however. And as far as President Obama was concerned, Thursday's ruling closed the debate over the law.

"After more than 50 votes in congress to weaken or repeal this law, after a presidential election based on preserving or repealing this law, after multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay," he said in a brief address from the Rose Garden on Thursday. "My greatest hope is that rather than keep refighting battles that have been settled again and again and again, I can work with Republicans and Democrats to move forward. Let's join together. Make health care in America even better."

Fat chance, Republicans promptly replied.

Many in the GOP scorned the ruling, saying the judges are legislating from the bench by prioritizing the law's intent over its text, which states that only consumers who buy insurance through an exchange "established by the state" are entitled to subsidies.

While their judicial avenues for overturning the law are probably now closed, Republicans are now turning to Congress, where they control both chambers, and to the presidential race, in which GOP candidates are running hard on a promise to repeal Obamacare.

In short, it seems the debate over the law is likely to persist for at least another election cycle, if not longer. Here are five signs the fight over the Affordable Care Act isn't finished.

GOP presidential candidates are still vowing repeal

Former Florida Governor and possible Republican presidential candidate Jeb Bush speaks at the CDU Economics Conference of the Economic Council on June 09, 2015 in Berlin, Germany. Axel Schmidt, Getty Images

One by one, the reactions from the GOP's presidential candidates to Thursday's ruling trickled in. And one by one, they defied the court's decision and vowed to overturn the law, come what may.

"This decision is not the end of the fight against Obamacare," said former Florida Gov. Jeb Bush. "As President of the United States, I would make fixing our broken health care system one of my top priorities. I will work with Congress to repeal and replace this flawed law with conservative reforms that empower consumers with more choices and control over their health care decisions."

Antonin Scalia on Obamacare ruling: "Start calling this SCOTUScare" 04:00

Ditto Texas Sen. Ted Cruz: "I remain fully committed to the repeal of Obamacare--every single word of it. And, in 2017, we will do exactly that."

And here's Louisiana Gov. Bobby Jindal: "Today, the Supreme Court had its say; soon, the American people will have theirs. President Obama would like this to be the end of the debate on Obamacare, but it isn't...Republicans must outline a clear and coherent vision for health care to win the trust of the American people to repeal Obamacare."

And Florida Sen. Marco Rubio, on Twitter: "Despite the Court's decision, ObamaCare is still a bad law that is having a negative impact on our country and on millions of Americans....I remain committed to repealing this bad law and replacing it."

When a party's presidential candidates are this closely synchronized on a major issue, you can be sure it will remain a subject of debate right through Election Day 2016 - and probably beyond.

Both parties are raising money off the decision

istockphoto

They say you can learn a lot in politics by following the money. If that's true, the bipartisan fundraising solicitations that came out in the wake of Thursday's Supreme Court decision show the political system isn't finished playing football with Obamacare just yet.

Democratic candidates welcomed the ruling and urged their supporters to donate money to ensure an Obamacare supporter takes the White House in 2016.

"Supporters of health reform won at the Supreme Court this morning, but if you think we're done fighting to protect the progress we've made, you should think again," explained an an email from Hillary Clinton's presidential campaign. The email, with a subject line that read "The health care fight isn't over," urged supporters to "Chip in $1 or more and let's keep fighting for health care."

One of Clinton's long shot challengers, former Maryland Gov. Martin O'Malley, sent a similar email, stressing the importance of building "upon this hard won progress" and urging supporters to donate $25.

Republicans, too, saw the fundraising potential in the ruling, urging their supporters to chip in and help elect a president who will undo the health care law.

"This is the direct result of President Obama. He deliberately forced ObamaCare on the American people in a partisan and toxic way, and we both know that Hillary Clinton will be more of the same. We cannot let this happen," warned an email from Bush's campaign. "That is why I need you to make a one time - emergency contribution of $50, $25, or $10 to my campaign to ensure that NEVER happens."

GOP congressional leaders remain on the warpath

In this file photo, U.S. Speaker of the House John Boehner, R-Ohio, (L) and Senate Minority Leader Mitch McConnell, R-Kentucky, (R) answer questions at the U.S. Capitol February 29, 2012 in Washington, DC. Win McNamee, Getty Images

They might not be able to do much about it with President Obama in the White House, but Republican leaders remain as opposed to the law as they ever were, Supreme Court ruling or no.

"Today's ruling won't change Obamacare's multitude of broken promises, including the one that resulted in millions of Americans losing the coverage they had and wanted to keep," said Senate Majority Leader Mitch McConnell, R-Kentucky, in a floor speech after the ruling landed. "The politicians who forced Obamacare on the American people now have a choice: crow about Obamacare's latest wobble towards the edge, or work with us to address the ongoing negative impact of a 2,000-page law that continues to make life miserable for too many of the same people it purported to help."

Republican leaders address Obamacare 01:57

House Speaker John Boehner, R-Ohio, said Thursday's ruling doesn't change the fact that "Obamacare is fundamentally broken." Republicans, he vowed, "will continue our efforts to repeal the law and replace it with patient-centered solutions."

House Majority Leader Kevin McCarthy, R-California, offered a similar take: "One thing that today's ruling does confirm is that we must repeal and replace this fundamentally flawed law. The House will continue to work toward a patient-centered solution and to help those who have felt the hardships this law has caused."

Statements like that don't leave much room for interpretation - congressional Republicans still want to scrap this law, and if they have to wait for a Republican to take the White House to accomplish that, so be it.

Democrats are going on offense

U.S. President Barack Obama (R), flanked by Vice President Joe Biden (L), gives a statement on the Supreme Court health care decision in the Rose Garden at the White House on June 25, 2015 in Washington, DC. Alex Wong, Getty Images

It's not just Republicans looking ahead to the next fight over Obamacare - while the GOP is examining ways to repeal the law, Democrats are seeking to expand its reach.

Their first goal: pressuring the 21 states that have not yet decided to expand Medicaid under the Affordable Care Act to do so.

Obama: "Wrong" for some states to refuse to expand Medicaid 00:40

"I'm going to work as hard as I can to convince more governors and state legislatures to take advantage of the law, put politics aside, and expand Medicaid and cover their citizens," the president said Thursday. "We've still got states out there that, for political reasons, are not covering millions of people that they could be covering, despite the fact that the federal government is picking up the tab. So we've got more work to do."

Rep. Steve Cohen, D-Tennessee, hailed the Supreme Court's ruling in a statement, using the decision to pressure Tennessee's Republican governor and GOP-controlled state legislature to expand Medicaid.

"I...remain hopeful that the Tennessee General Assembly will finally act to expand Medicaid so that our citizens can access the same benefits of the law that residents of other states do," Cohen said.

Public opinion remains fairly split

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Republicans remain convinced that public opinion is still on their side in the debate over Obamacare. Five years after the law's passage, they argue, Americans still aren't sold on it.

"I believe 2016 will be a national referendum on repealing Obamacare," Texas Sen. Ted Cruz said in a floor speech on Thursday. "This law is profoundly unpopular. It's unpopular with Republicans, it's unpopular with independents, it's unpopular with Democrats, it's unpopular with young people, it's unpopular with Hispanics, it's unpopular with everybody it is hurting - and there are millions being hurt by this law."

5 years of Obamacare 00:37

Polls do reflect that the public is still fairly split on the law - 44 percent of Americans said they disapprove of Obamacare in a CBS News-New York Times poll released Monday, while 47 percent said they approve of it.

As long as the percentage favoring Obamacare remains short of a majority, it's likely Republicans will continue talking about repeal.

The GOP should beware of taking the law's unpopularity as a foregone conclusion, however, because there is some evidence that attitudes are shifting. Monday's poll actually marked the first time the law's supporters outnumbered the law's opponents in a CBS survey. Last month, 43 percent of Americans said they approve of the law, while 52 percent said they disapprove. And in November 2013, those numbers were even more lopsided, with 31 percent in favor and 61 percent opposed.

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