Topeka ? When the federal government first began offering subsidized health insurance on the federal “exchange” marketplace, Gotfred Beardshear and his wife were among the first local residents to get in line.

“The first year, I got a total hip replacement,” said Beardshear, 62, who owns Blackbird’s Trading Post in Lawrence with his wife, Cynthia Trask. “Without it, I’d be in a wheelchair waiting to get on Medicare when I turn 65. It’s revolutionized my existence. I’m walking.”

Beardshear and his wife are among the 4,941 people in Douglas County who have received subsidized health policies through the federal exchange, according to Heartland Community Health Center, the local agency that serves as a “navigator” to help people buy insurance through the exchange.

And so when the news arrived Thursday that the U.S. Supreme Court had upheld the legality of those subsidies, Beardshear said he was greatly relieved.

“I think it’s important for people to know, real people have benefited from this. It’s not just spin,” Beardshear said.

Beardshear and others in Kansas were at risk of losing their insurance if the Supreme Court had ruled the other way.

Under the Affordable Care Act, also known as Obamacare, most working-age adults and their dependents have been required to carry health insurance since Jan. 1, 2014, or pay a tax penalty.

One of the ways it provides for people to obtain insurance if it’s not available through their workplace is through Internet-based “exchange” marketplaces. The law authorizes each state to set up its own exchange, but for residents of states that choose not to establish one, it provides for a federal exchange run by the Department of Health and Human Services.

Kansas is among the states that have not formed their own exchange. Although the state received a $31.5 million grant in 2010 to set one up, newly elected Gov. Sam Brownback, a Republican, opted the next year to reject that grant and not to establish a Kansas exchange.

The lawsuit, King v. Burwell, filed by a group of individuals in Virginia, challenged a technical portion of the law that said the tax credits were available to people who bought policies through “an Exchange established by the State.”

But in a 6-3 decision, the Supreme Court said Thursday that the wording of the law was ambiguous and that it was reasonable to conclude that Congress meant for the tax credits to apply to people who enroll through the federal exchange, as well as through state-established exchanges.

HHS reported in March that in Kansas, 85,490 people had enrolled through the exchange, and of those, 69,979 had received subsidies.

According to estimates by the Kaiser Family Foundation, those subsidies amount to nearly $14.7 million a month in Kansas alone. And if the Supreme Court had struck down subsidies for the federal exchange, the people receiving those subsidies would have seen an average increase of 231 percent in the cost of their policies.

Gene Meyer, president and CEO of Lawrence Memorial Hospital, said he was also relieved by Thursday’s decision. That’s because as more people in the community are able to get health coverage, the less the hospital has to spend in providing uncompensated or “charity” care.

“Total uncompensated care at LMH in 2014 was bout $27 million,” Meyer said. “It’s still pretty substantial. But we’ve actually seen that number go down a little bit because of people’s ability to get health insurance.”

Officials at the Kansas Hospital Association also praised the decision.

“Today marks another milestone for Kansans who can now continue to afford health insurance through the federal exchange,” KHA said in a statement Thursday. “With fewer uninsured, hospitals can continue to provide our patients with preventative care and necessary treatment in a timely manner. All Kansans will benefits from this decision.”

But Republicans who have opposed the Affordable Care Act since its inception, including Kansas Congresswoman Lynn Jenkins, called the decision disappointing and said they would continue fighting to repeal or amend the law.

“Today’s disappointing decision does not change the hardships that folks around Kansas and across the nation are facing as they continue to deal with the uncertainty and failed promises of the president’s broken healthcare law,” said Jenkins, whose district includes Lawrence.

“While the health care delivery system had problems prior to the president’s health care law, under his fundamentally flawed law it is still not working and remains just as burdensome, confusing and expensive as the day it came into existence,” she said in a statement posted on her website. “I remain committed to fixing this mess and implementing better health care solutions that lower costs and empower patients to choose the care that’s right for them.”