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Administrative Law Keyed to Breyer
King v. Burwell
Citation:
135 S. Ct. 2480 (2015)Facts
The Affordable Care Act established three major reforms to expand health insurance coverage: (1) guaranteed issue and community rating requirements preventing insurers from denying coverage or charging higher premiums based on health status; (2) an individual mandate requiring individuals to maintain health insurance or make a payment to the IRS; and (3) tax credits to make insurance more affordable for lower-income individuals. The Act required each state to establish an “Exchange” where people could purchase insurance, but provided that the federal government would establish an Exchange if a state failed to do so. Section 36B of the Internal Revenue Code provided tax credits for insurance purchased through “an Exchange established by the State.” The IRS issued a rule interpreting this provision to include both state and federal Exchanges. The petitioners, who lived in Virginia (which had a federal Exchange), challenged this interpretation. They argued that without tax credits, the cost of insurance would exceed 8% of their income, exempting them from the individual mandate’s coverage requirement.
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