I would like to offer a point about the King v. Burwell case now before the U.S. Supreme Court (“Poll: Most in U.S. don’t know of Supreme Court health care case,” March 20, Page A2) that I have not seen mentioned.

The plaintiffs in the case argue that the wording of the Affordable Care Act does not allow premium subsidies to be given to people who obtained their ACA health policies through a federal exchange.

Their reason is that the law says that such subsidies are available only to people with policies obtained through exchanges set up by “the State.” The plaintiffs take “the State” to mean a particular state in the union – Maine, Texas, etc.

This is nitpicking, because it is widely acknowledged that the intent of the ACA was that everyone holding a policy obtained through it should be eligible for premium subsidies, no matter what the source of the policy was – state exchange or federal exchange.

If, however, lawyers and judges are willing to give weight to such nitpicking, they should surely seriously consider that “the State” also means the whole apparatus of a nation’s government (as in Louis XIV’s alleged declaration, literally translated, “the State, it is I”). The term “State” thus embraces federal government and individual state government.

Peter Bakewell

Bath


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