ap photo President Joe Biden speaks in the East Room of the White House Thursday in Washington. The Supreme Court has dismissed a third major challenge to “Obamacare,” preserving health insurance coverage for millions of Americans.

WASHINGTON — The Supreme Court, though increasingly conservative in makeup, rejected the latest major Republican-led effort to kill the national health care law known as “Obamacare” on Thursday, preserving insurance coverage for millions of Americans.

The justices, by a 7-2 vote, left the entire Affordable Care Act intact in ruling that Texas, other GOP-led states and two individuals had no right to bring their lawsuit in federal court. The Biden administration says 31 million people have health insurance because of the law, which also survived two earlier challenges in the Supreme Court.

The law’s major provisions include protections for people with existing health conditions, a range of no-cost preventive services, expansion of the Medicaid program that insures lower-income people and access to health insurance markets offering subsidized plans.

“The Affordable Care Act remains the law of the land,” President Joe Biden, said, celebrating the ruling. He called for building further on the law that was enacted in 2010 when he was vice president.

Also left in place is the law’s now-toothless requirement that people have health insurance or pay a penalty. Congress rendered that provision irrelevant in 2017 when it reduced the penalty to zero.

The elimination of the penalty had become the hook that Texas and other GOP-led states, as well as the Trump administration, used to attack the entire law. They argued that without the mandate, a pillar of the law when it was passed, the rest of the law should fall, too.

And with a Supreme Court that includes three appointees of former President Donald Trump, opponents of “Obamacare” hoped a majority of the justices would finally kill the law they have been fighting for more than a decade.

But the third major attack on the law at the Supreme Court ended the way the first two did, with a majority of the court rebuffing efforts to gut the law or get rid of it altogether.

Trump’s appointees — Justices Amy Coney Barrett, Neil Gorsuch and Brett Kavanaugh — split their votes. Kavanaugh and Barrett joined the majority. Gorsuch was in dissent, signing on to an opinion from Justice Samuel Alito.

Justice Stephen Breyer wrote for the court that the states and people who filed a federal lawsuit “have failed to show that they have standing to attack as unconstitutional the Act’s minimum essential coverage provision.”

In dissent, Alito wrote, “Today’s decision is the third installment in our epic Affordable Care Act trilogy, and it follows the same pattern as installments one and two. In all three episodes, with the Affordable Care Act facing a serious threat, the Court has pulled off an improbable rescue.” Alito was a dissenter in the two earlier cases in 2012 and 2015, as well.