Washington DC — On Thursday, the Supreme Court upheld Obamacare for the third time and rejected a sweeping challenge backed by former President Donald Trump and Republican state attorneys.

The decision preserves health insurance subsidies for more than 20 million Americans and protections for tens of millions more whose preexisting medical conditions could otherwise prevent them from obtaining coverage.

"Today’s Supreme Court ruling once again underscored the incredible strength of the ACA," The White House's official Twitter account announced. "A record 31 million people have enrolled in health care through the law."

The ruling stands as a final thumbs-down verdict against Trump’s promise that he would "repeal and replace" the 2010 Affordable Care Act sponsored by President Barack Obama.

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Trump never devised a plan to replace the law, and both the Republican-controlled Senate and the high court with a solidly conservative majority rejected his legislative and legal bids to repeal it.

The justices decided that Congress sought to improve the law in 2017, not repeal it, when lawmakers reduced the tax penalty to zero for those who did not buy health insurance.

Texas Attorney General Ken Paxton filed a suit in 2018 contending the entire law should be struck down because the mandate to buy insurance stood as a pillar that upheld the structure of the whole measure.

The case, California vs. Texas, became a battle of red states vs. blue states, driven by elected state attorneys. Paxton’s suit was joined by 19 other Republican-led states as well as lawyers for the Trump administration.

Because Trump’s Justice Department took the side of the challengers, then-California Attorney General Xavier Becerra stepped forward to defend the law, and he had the backing of 20 other Democratic-led states and the U.S. House of Representatives.

Paxton filed his suit in Fort Worth, Texas, and a federal judge there agreed the entire health care law must be struck down. The U.S. appeals court in New Orleans agreed in large measure, but told the judge to reconsider the scope of this ruling.

The California attorney general urged the Supreme Court to take up the appeal on a fast-track basis. At the time, there were five justices on the court who had upheld the law twice before, including Justice Ruth Bader Ginsburg. After she passed away in September, and her seat was filled by Trump’s third appointee, Justice Amy Coney Barrett.

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The court heard arguments in the case in early November, a week after Trump was defeated by Joe Biden. And upon taking office, the new president chose Becerra to head the Department of Health and Human Services, which administers the law.

Many believe it is a huge win for affordable healthcare nationwide.