In King v. Burwell, what did the Supreme Court decide regarding premium subsidies?

• A. Supreme Court ruled subsidies available for federal exchange
• B. Supreme Court ruled subsidies illegal nationwide
• C. Supreme Court ruled subsidies only for state exchanges
• D. Supreme Court avoided ruling

Answer: (A)

At the heart of this question is how the ACA’s premium tax credits are lawfully available to people, regardless of whether their insurance is purchased on a state-established exchange or the federal exchange. In King v. Burwell, the Supreme Court held that these subsidies are available on the federal exchange as well as on state exchanges. The reasoning centers on the text and purpose of the law: while the statute says subsidies are available for exchanges “established by the State,” reading it to exclude the federal exchange would undermine the law’s fundamental goal of making insurance affordable for many Americans, especially those in states that rely on the federal exchange. Interpreting the statute to allow subsidies on the federal exchange preserves the Act’s broad coverage and ensures that the tax credits continue to help people obtain affordable insurance regardless of which exchange operates in their state. The other options do not fit because they contradict the Court’s interpretation that the subsidies should be available nationwide through both types of exchanges, and because the Court did not avoid ruling on this issue.