The Patient Protection and Affordable Care Act is more than 900 pages long, but the U.S. Supreme Court case King v. Burwell, which challenges the healthcare insurance exchange subsidies for individuals who obtain healthcare insurance through federally-run exchanges, hinges on just four words.
The PPACA states tax subsidies for health insurance are to be provided through an exchange "established by the state." Based on the text of the law, lawsuits were filed challenging an IRS regulation that allows for subsidies in all states.
A recent New York Times article looked closer at the wording "established by the state" and the intention behind writing it.
Here are four things to know about those four words.
1. Based on interviews with more than 24 Democrats and Republicans involved in writing the PPACA, the words were "a product of shifting politics and a sloppy merging of different versions," according to the report.
2. Some of the interviewees described the words as "inadvertent," "inartful" or "a drafting error."
3. None of the interviewees supported the contention of the plaintiffs in King v. Burwell, according to the report.
4. Plaintiffs claim the law allows subsidies solely where marketplaces have been "established by the state." However, those who drafted the PPACA say they did not intend to make that distinction, according to The New York Times.
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