On the morning of June 25, 2015, the Supreme Court decided King v. Burwell, a landmark case regarding the Patient Protection and Affordable Care Act (ACA). At the heart of the case is the statutory interpretation of a phrase in a provision dealing with the distribution of tax credits for the purchase of health insurance on the health insurance marketplaces known as "exchanges" [1-3]. The extension of federal tax credits to lower-income citizens for the purchase of health care is one of three major reforms mandated by the ACA [4]. The plaintiffs argued that those who bought insurance on federal exchanges were not eligible for tax credits because the states in which they resided had not created their own exchanges, and the ACA only provided tax credits to citizens who used "an Exchange established by the State" [5]. The defendants, several government agencies, claimed that exchanges created by the federal Department of Health and Human Services (HHS) qualified as exchanges "established by the State" [6]. After much testimony, the Supreme Court interpreted the phrase to include the federal HHS exchanges [7], thereby making users of HHS exchanges eligible to receive tax credits [7].
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