“Established by the State”: Textualism and the Affordable Care Act

When the Patient Protection and Affordable Care Act was passed in 2009, everyone had an opinion.  Also known as the ACA or Obamacare, the law established the biggest reform to health care since Medicaid was established in the 1960s.  It has brought a heated debate and has been brought for repeal before the Senate 56 times.  The latest attempt to invalidate Obamacare hinges on four words: “established by the State”.

Obamacare makes health insurance affordable by creating tax subsidies to help alleviate the financial burden of mandatory coverage.  The text of the law states , “The premium assistance amount … is the amount equal to the lesser of the monthly premiums for such month for 1 or more qualified health plans offered in the individual market within a State which cover the taxpayer…and which were enrolled in through an Exchange established by the State…”  In layman’s terms, this small subsection is explaining how the subsidies are calculated.  For a few detractors, including the plaintiffs in the King vs. Burwell case that is before the Supreme Court, the way this is phrased eliminates tax subsidies from exchanges run by the federal government.  Their argument is that these tax credits are only legitimate and should only be available in the 16 states with state-run marketplaces, and the other states do not have the power to subsidies the expenses.

Proponents of the Affordable Care Act deny this reliance on the “letter of the law” interpretation.  In context, they argue, the subsidies are for both state- and federally-run exchanges.  The hang-up on those four words in a 1,000+ page law is a last-ditch attempt to invalidate a law that has allowed those who previously could not get insurance to be covered.

So, what do you think?  Do these four words invalidate the intent of the law?  Should we take context into account?  How do you predict various justices will rule on this case?

Gorod, Brianne. “Supreme Court Chief Justice Likely to Back Healthcare Law.” Los Angeles Times. Los Angeles Times, 26 Feb. 2015. Web. 1 Mar. 2015. http://www.latimes.com/opinion/op-ed/la-oe-0227-gorod-obamacare-scotus-20150225-story.html

Pear, Robert. “House G.O.P. Again Votes to Repeal Health Care Law.” The New York Times. The New York Times, 3 Feb. 2015. Web. 1 Mar. 2015. http://www.nytimes.com/2015/02/04/us/politics/house-gop-again-votes-to-repeal-health-care-law.html?_r=0

The Editorial Board. “The Phony Legal Attack on Health Care.” The New York Times. The New York Times, 28 Feb. 2015. Web. 1 Mar. 2015. http://www.nytimes.com/2015/03/01/opinion/sunday/the-phony-legal-attack-on-health-care.html

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