It was a long-awaited ruling, and it was a doozy. A three-judge panel of the Federal Circuit Court for the District of Columbia decided the Halbig case Tuesday, ruling that under President Obama‘s signature legislative achievement only health insurance exchanges “established by the State” can award subsidies to consumers for purchasing health insurance and penalize the employers of those who receive the subsidies. The federal exchange, which is being used in 36 states, can do neither. That’s the clear meaning of the Affordable Care Act, according to the panel majority.

The Supreme Court will likely have to settle this issue next year because another appeals court has ruled the opposite. But if Halbig is upheld and nothing else changes, Americans will get an even worse version of Obamacare — one that causes enormous upward pressure on insurance premiums but without subsidies to offset the pain.