KING VS.

BURWELL

King vs. Burwell and Implications

Ashley Winans
HCA 600
3/28/2015
Professor Tracy Yee

KING VS. BURWELL

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King vs. Burwell and Implications

Th King vs. Burwell case asserts that the text of the ACA only allows for subsidies on
state-run exchanges, and that the regulation as implemented by the IRS, providing for subsidies
on state-run exchanges as well as federal exchanges, exceeded the authority Congress granted to
it (Somnin, 2015, P.1). This case has the potential to cost 13 million Americans over $25 billion
as well as cost them their health insurance as they cannot afford this insurance without certain
tax breaks.
When the ACA was being written, the (unwritten) assumption was that all states would
take part in the Healthcare Marketplace; however, 37 states operate under a form of the federally
run or supported exchanges. Most of those 37 states also have governors or legislators who tend
to be more conservative and also opposed the Affordable Care Act as well as refused to
implement a state exchange. If these states has instead decided to created a state run exchange,
the citizens of these states would not have had their tax breaks affected by this particular case.
This is partially due to the ambiguous language used in drafting the ACA regarding the
exchange established by the State.
In the King vs. Burwell case, the plaintiffs contended that the IRSs interpretation is
contrary to the language of the statute It is asserted that the language of the statue
authorizes tax credits only for individuals who purchase insurance on state-run Exchanges.
However, the statutory language remains ambiguous and has been subjected to multiple
interpretations.
ACA opponents have brought this particular suit in order to deny tax support which
would essentially be used to offset the costs of medical coverage for many low and middle
income families. If this suit is successful, the aforementioned individuals will no longer have tax

KING VS. BURWELL

support and will be left without coverage. Additionally, it can potentially put an end to federally
run competitive state-based health insurance exchanges. The outcome of the King vs. Burwell
case has the potential to determine whether millions of people continue to have access to
affordable, comprehensive health insurance.
One possible solution is for Congress to amend this law with the three words or federal
government and instead say: Exchange established by the state or federal government when
they are defining the tax credit eligibility. Congress perspective is that state government
officials never understood the tax credits to be limited to state-run Exchanges, whereas member
of Congress understood that tax credits would be available to purchasers on all of the
Exchanges (Constitutional Accountability Center, 2015).

KING VS. BURWELL

References
King v. Burwell, U.S. Supreme Court. (n.d.). Constitutional Accountability Center:King v.
Burwell. Retrieved from: http://theusconstitution.org/cases/king-v-burwell.
Shi, L., & Signh, D. (2012). Delivering health care in America: A systems approach (5th ed.).
Burlington, MA: Jones & Bartlett Learning.
Somnin, Ilya. (2015). Federalism Arguments in King vs. Burwell. Retrieved March 27, 2015,
from http://www.washingtonpost.com/news/volokhconspiracy/wp/2015/03/07/federalism-arguments-in-king-v-burwell/

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APPENDIX A
Attach your appendix item here. If no appendices are needed, then omit this page. If more than
one appendix is needed, continue to the following page, place APPENDIX B (in all caps)
centered at the top of the page, and then attach the applicable item (e.g., table, figure, graph,
illustration, etc.). Continue the same process as necessary for all subsequent appendices.