The US Supreme Court has upheld a disputed portion of President Barack Obama's landmark health care reform, in a major legacy-building victory for his administration.
By a margin of six to three, the judges ruled in favour of allowing the federal government to subsidise health insurance by giving tax credits to consumers nationwide.
A triumphant Obama quickly hailed the ruling, calling it a win for "hard-working Americans all across this country".
"This law is working and it's going to keep doing just that," he said.
Opponents of the Affordable Care Act - better known as Obamacare - had argued that it was unconstitutional for the federal government to subsidise insurance in this way in states that refused to set up their own insurance exchanges.
The narrow question before the court was whether some seven million people who signed up for Obamacare via the government's website were actually entitled to tax subsidies that make the coverage affordable.
But the high court ruled that the law should stand, with two usually conservative justices joining the four generally liberal members of the panel to overturn the challenge.
In a ruling read out by Chief Justice John Roberts, the bench argued that it was clear that the original law had been intended to permit federal subsidies in all states.
Failure to do so would have condemned the law to a "death spiral" by destabilising the insurance market in states with federally run exchanges, Justice Sonia Sotomayor had said in March.
"It thus stands to reason that Congress meant for those provisions to apply in every state as well... tax credits are available to individuals in States that have a federal exchange," the ruling said.
Republicans have mounted several legislative attacks on the law in parallel to the legal assaults and this is the second time in three years that the court has saved it.
For Obama, the ruling marked a major victory that cements his signature domestic policy achievement.
"Five years in, this is no longer about a law. This is not about the Affordable Care Act as legislation or Obamacare as a political football. This is health care in America," the president said in the White House Rose Garden.
But Republicans have reacted angrily.
"Republicans will continue to fight tooth and nail to repeal this oppressive law," declared Senator John Cornyn, the party's number two leader in the senate.
"Today's decision doesn't change the fact that Obamacare has been a disaster for the millions of hardworking American families who have seen their health care costs skyrocket or lost their insurance entirely."
Several Republican contenders in the 2016 presidential race to succeed Obama also slammed the ruling.
White House hopeful, Jeb Bush, called it a "fatally flawed law" and added: "This decision is not the end of the fight against Obamacare."
Democratic presidential candidate Hillary Clinton meanwhile tweeted: "Yes! SCOTUS affirms what we know is true in our hearts & under the law: Health insurance should be affordable & available to all."
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