Health-Care Law Arguments: A Big Battle Over Four Words

The fundamental question facing the justices in the latest challenge to the 2010 Affordable Care Act has nothing to do with health care: how to interpret a tiny snippet – specifically, four words — embedded in the voluminous law.

First, some background: Congress in the law authorized the government to provide tax credits for insurance purchases by middle- and low-income people. The credits are vital to the program.

The law says that those who purchase coverage through an exchange “established by the state” are eligible for the credits. More than two-thirds of the states declined to set up their own exchanges. Currently, residents in 37 states can purchase insurance through HealthCare.gov, the federal exchange.

The key question for the justices: What is meant by “established by the state”?

The challengers argue that the credits are available only to those who buy coverage through one of the state exchanges, that is, exchanges “established by the state.” The Obama administration argues, however, that the language refers not just to the states that have set up their own exchanges, but also to the others, where exchanges are operated by the federal government.

The Internal Revenue Service, one of the agencies tasked with implementing the health-care law, sided with the administration’s interpretation.

When faced with differences over statutory language, the Supreme Court typically looks to one of its own rulings, a 30-year-old matter known colloquially as the “Chevron” case.

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