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Supreme Court case could upend Affordable Care Act

BMJ 2015; 350 doi: (Published 02 March 2015) Cite this as: BMJ 2015;350:h1162
  1. Michael McCarthy
  1. 1Seattle

The US Supreme Court will hear oral arguments on Wednesday 4 March in a case that, should the justices decide for the plaintiffs, could potentially eviscerate the 2010 Affordable Care Act.

In the case King versus Burwell the plaintiffs argue that federal subsidies that have helped millions of US consumers to purchase health insurance coverage through the federal exchange created by the 2010 act are illegal.1

At issue are five words in the law that state that the subsidies would be made available through an “exchange established by the state.” Unexpectedly, only 13 states and the District of Columbia elected to set up their own exchanges, with the rest opting …

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