July 13, 2015

The Final Word: King v. Burwell

As you no doubt know by now, the Supreme Court issued its ruling in the King v. Burwell case on June 25. Based on its interpretation of disputed language in the Affordable Care Act, the Court held (6-3) that premium subsidies under the Affordable Care Act (ACA) can be provided to consumers in all states, not just those in states that established their own health insurance exchanges. 


At issue in the case was the administration’s (IRS’s) interpretation of the statute’s ambiguous language describing the exchanges from which people must purchase insurance in order to be eligible for a premium subsidy. The agency interpreted the phrase “exchange established by the state” to include the federal exchange, while the challengers thought the language should be read narrowly.


The Court’s rationale for its holding was more favorable than it might have been. Often, courts reason that they should defer to an agency’s interpretation of ambiguous language in a law. If the Court had relied on this basis for its ruling, then the IRS under a future president could interpret the law more narrowly. But in this case, the Court reasoned that the structure of the law allowed for only one correct interpretation of the ambiguous language. Thus, a future administration cannot re-interpret it.


Those who want to delve into the case might find the following resources to be helpful:


  • The Court’s opinion, written by Chief Justice Roberts, and the dissent, written by Justice Scalia, joined by Justices Thomas and Alito. (4-p. syllabus, 21-p. opinion, 20-p. dissent)
  • Opinion explained “In Plain English” from SCOTUS Blog (fairly short)
  • Opinion analysis (also easy to read) from SCOTUS Blog (fairly short)
  • Health Affairs blog post by health law professor Timothy Jost (more detailed, a little longer than others, but still easy to read)