On June 25, the Supreme Court upheld the availability of subsidies in all 50states under the Patient Protection and Affordable Care Act. Thecourt affirmed in a 6–3 vote that the language in PPACA allows thegovernment to help people buy insurance (through subsidies or taxcredits) anywhere in the country and not only in states that haveestablished their own insurance exchanges. Chief Justice JohnRoberts wrote for the majority. Justices Scalia, Thomas and Alitodissented.

The court cited examples in the PPACA of “inartful drafting” andfound “relevant provisions to be ambiguous.” The court furtherexplained that the tax credits were necessary for the federalexchanges to function like state exchanges to avoid “the type ofcalamitous result that Congress plainly meant to avoid.” JusticeScalia wrote in his sharp dissent to the decision that “words nolonger have meaning if an exchange that is not established by astate is ‘established by the State.’”

The King v. Burwell ruling is the second casewhere the Supreme Court has decided in favor of the PPACA, allowingmillions of qualified individuals to keep the tax subsidies thathelp them afford to purchase health insurance coverage on a stateor federal exchange.

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