While most folks were watching the latest enrollment numbers for the Affordable Care Act, opponents of the national health care reform law were continuing their fight in the federal court system.
This particular attack on Obamacare, as it is popularly known, was once again based on taxes. And now that legal strategy is over.
A federal judge on Jan. 15 rejected an effort to disallow tax credits for individuals who get medical coverage in the 36 states that rely on federal health care exchanges to sign up people for insurance.
State vs. federal exchange insurance
The plaintiffs in Halbig v. Sebelius had argued that Congress had intended for the law to provide tax subsidies only for individuals who bought health insurance through their own states' exchanges.
The subsidy, known as the Premium Tax Credit, will be figured on individuals' tax returns beginning with 2014 filings during 2015, to help reimburse some of the cost of buying their own health insurance.
This tax break, Halbig plaintiffs argued, was an incentive for states to assume responsibility for and the burden of creating and maintaining Obamacare marketplaces.
However, only 14 states have set up health care exchanges.
The Obamacare opponents had argued that the Internal Revenue Service overstepped its legal authority by allowing the same tax credits to everyone, regardless of whether they bought their health coverage on a state or federally run exchange.
D.C. District Court Judge Paul Friedman rejected that argument. In his 39-page ruling, Friedman affirmed that Congress intended to provide tax subsidies to any exchange, whether run by a state or the federal government.
Tax subsidies for all purchasers
This case was considered by opponents of Obamacare as the last best chance to legally bury the health care law they so hate.
To them, the legislative language was clear that people who live in states where ACA-mandated insurance is available through a federal exchange instead of a state exchange are not eligible for the tax credit.
ACA supporters, however, said the lawsuit was just legal straw-grasping. Timothy Jost, a law professor at Washington and Lee in Lexington, Va., wrote in 2011 that the ACA "requests the states to establish" health care insurance exchanges and sets out the duties of the exchanges. The law also, noted Jost, "provides that if a state elects not to establish an exchange or fails to do so, HHS (Health and Human Services) must 'establish and operate' an exchange in such a state and 'take such actions as are necessary to implement' the other requirements" of the health care law.
Three years after Jost's analysis, Judge Friedman found essentially the same thing.
Congressional intent, too
Friedman also noted legislative intent in his opinion. "The relevant legislative history does not demonstrate that Congress intended to limit the premium tax credit to State Exchanges," he wrote.
"The problem that plaintiffs confront in pressing this argument (that Congress intended tax credits only for state exchanges) is that there is simply no evidence in the statute itself or in the legislative history of any intent by Congress to ensure that states established their own Exchanges," wrote Friedman later in his decision. "And when counsel for plaintiffs was asked about this at oral argument, he could point to none."
Once again a tax provision is key to a legal challenge to Obamacare.
Just as happened in 2010 when the U.S. Supreme Court upheld the individual mandate tax in declaring the health care reform law constitutional, the legality of the insurance exchange tax credit now affirms Obamacare.
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Veteran contributing editor Kay Bell is the author of the book "The Truth About Paying Fewer Taxes" and co-author of the e-book "Future Millionaires' Guidebook."