The Affordable Care Act in front of the Supreme Court of The United States again

by | Mar 30, 2015 | Affordable Care Act | 1 comment

The latest constitutional question related to the Affordable Care Act was addressed on March 4, 2015 when the United State Supreme Court heard oral arguments in the case of King vs. Burwell. This decision could affect 38,000 enrollees in New Hampshire and 67,000 enrollees in Maine but none in Vermont. This case calls into question just part of the law and not the Affordable Care Act in its entirety.

If the court agrees with the plaintiff, residents of New Hampshire and Maine would not be eligible for tax subsidies through Health Care Exchanges because they are operated by the federal government rather than the state. Since Vermont is a state run exchange Vermont residents would not be affected by the outcome.

The controversy all comes down a single line in a very lengthy law stating, people could receive a tax subsidy for health coverage if they enroll “through an exchange established by the State.” Only 14 states qualify by that narrow definition, Vermont being one of them. However New Hampshire and Maine do not. The Internal Revenue Service ruled that the law applies to each exchange regardless of whether the exchange is set up by a state or the federal government.

Attorneys for King argue that Congress intentionally put this in the law as a carrot to encourage states to establish their own state run Health Exchanges. The attorneys arguing for the government agree with the Internal Revenue Service’s interpretation, in that the law applies to all of the state Health Care Exchanges regardless of whether they are state-based, federally-facilitated partnership, or federally-supported state-based exchange.

Tom Raffio
March 2015

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