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ACA and Healthcare Reform

Williams Mullen: Supreme Court Upholds ACA Premium Assistance Nationwide

By: Brydon M. DeWitt

This morning [June 25], the Supreme Court ruled that Affordable Care Act (ACA) premium tax credits will remain available to individuals residing in states that did not establish their own health insurance marketplaces. 

In King v. Burwell, the Supreme Court analyzed ACA statutory language providing that premium assistance is available to individuals purchasing coverage through health insurance marketplaces “established by the State.” [enhanced  opinion available to subscribers] [ subscribers may access Supreme Court briefs for this case]. The petitioners, four Virginia residents, challenged the availability of premium assistance in Virginia because, like thirty-three other states, Virginia has not established a health insurance marketplace.  The federal government operates health insurance marketplaces in states that have not established their own marketplace.

The Court rejected the petitioners’ argument.  The Court reasoned that, within the context of other provisions of the Act, the phrase “established by the State” is ambiguous.  Then, considering the ACA’s purpose and structure, determined that Congress did not intend to limit the availability of premium assistance to individuals living in states that established a health insurance marketplace.

Consequently, there is no change to ACA benefits or compliance following today’s Supreme Court ruling.  Premium tax credits will continue to be available to people living in the thirty-four states that participate in federally-run health insurance marketplaces.  Employers with employees in states that have federally-run exchanges will continue to be subject to the ACA penalties for failure to offer ACA-compliant health insurance to such employees. 

Helpful information regarding employer compliance can be found here. Williams Mullen will continue to closely monitor developments in this area and provide updates.

About Williams Mullen

With approximately 300 attorneys practicing in over 30 practice areas, Williams Mullen provides comprehensive legal services to regional, national and international clients. Their clients include multinational Fortune 500 companies, private family-owned businesses, nonprofit organizations and government entities.  From offices in North Carolina, Virginia, Washington D.C. and London, Williams Mullen attorneys bring skills and experience to solving the legal needs of their diverse client base.

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