July 2015 - Parks & Recreation - 30
ADVOCACY
King v. Burwell: An Explainer
By Oliver Spurgeon III
J
une 25, the Supreme Court upheld one of the central tenets of the Affordable
Care Act (ACA). The Court ruled that the federal government can legally
provide tax credits to help low- and middle-income individuals purchase
health insurance. The Court's decision leaves the current health system
intact, which means that nothing should change for you, your family, friends or
coworkers. The law still requires Americans to have health insurance and large
employers - those with more than 50 full-time employees - to provide health
insurance for their employees. What follows is a summary of the decision.
Background: King v. Burwell
The ACA created marketplaces,
known as exchanges, where individuals can shop for health insurance.
Under the ACA, the IRS provides tax
credits to purchase health insurance
through exchanges for individuals and
households with incomes between 100
percent and 400 percent of the federal poverty threshold. The law allows
states to create their own exchanges,
and it also allows the federal government to step in and run exchanges
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when states refuse to create their own.
Currently, the federal government runs
exchanges in 37 states that declined
to create or run their own exchanges.
King v. Burwell focused on five words in
the ACA - " exchange established by
the State " - and was filed to determine
whether the federal government can
legally provide tax credits to purchase
health insurance through federally created exchanges. The plaintiffs argued
that no one in these 37 states should
be eligible for tax credits because the
| J U LY 2 0 1 5 | W W W. N R PA . O R G
ACA Primary Provisions:
1. Prevents denial of coverage by
insurers due to health reasons, and
bars insurers for charging higher
premiums due to health reasons
2. Requires individuals to maintain
health insurance or pay a fee,
unless insurance costs exceed 8
percent of their income
3. Provides tax credits to individuals
with incomes between 100 percent
and 400 percent of the federal poverty line to make health insurance
more affordable
4. Requires the creation of exchanges
in each state, allowing individuals
to compare and buy insurance
plans. In instances where states
refuse to create exchanges, the
federal government steps in to
establish and run them.
exchanges were created by the federal
government and are not an " exchange
established by the State. "
Supreme Court's Rationale
The ACA contains four primary provisions (see table). If any of these
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