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Legislation and Regulation Keyed to Manning, 5th Ed.
King v. Burwell
Citation:
135 S. Ct. 2480 (2015)Facts
The Affordable Care Act implemented three major reforms to expand health insurance coverage: (1) guaranteed issue and community rating requirements prohibiting 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 directed each state to establish an “Exchange” where people could shop for insurance, but provided that if a state chose not to establish an Exchange, the Secretary of HHS would “establish and operate such Exchange within the State.” The Act provided that tax credits were available to individuals who enrolled in insurance plans through “an Exchange established by the State under section 1311” of the Act. Despite this language, the IRS issued a rule making tax credits available on both state and federally-established Exchanges. The petitioners, who lived in Virginia (a state with a federal Exchange), challenged the IRS rule. They argued that without tax credits, the cost of insurance would exceed 8% of their income, exempting them from the individual mandate.
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