Supreme Court to Determine ACA’s Future

Elizabeth Fassbender

On March 4, 2015, the Supreme Court of the United States (SCOTUS) heard arguments in the case of King v. Burwell, which could threaten the future of the Affordable Care Act (ACA). Specifically, the Justices will be deciding the meaning of a section of the statute that stipulates subsidies are available through an exchange “established by the State.” According to the petitioners, the literal interpretation of the text means the Internal Revenue Service (IRS) can only provide subsidies to individuals in states that established their own exchanges. The government is arguing that the section refers to any exchange set up by the state, including an exchange run for the state by the federal government. A ruling is expected in late June.

Under the ACA, states had the option to either implement a state run health insurance exchange or let the federal government run the exchange instead. States running their own exchange are responsible for performing all functions of that exchange, including establishing procedures for enrolling individuals in health insurance and determining subsidy eligibility. In states that opt for a federally run exchange, the Department of Health and Human Services (HHS) performs all such functions, and individuals enroll through the website.

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