Everything in the legislative history that sheds light on what Congress intended supports the plain meaning of the language limiting premium subsidies to those who obtain coverage “through an Exchange established by the State.”
- The lead author of the ACA, then-Senate Finance Committee Chairman Max Baucus, D-Mont., had proposed — and even gotten Congress to enact — other health-insurance tax credits and subsidies that were conditioned on states taking certain actions.
- Senate Democrats similarly considered letting individual states opt out of the Democrats’ cherished “public option.”
- Congressional Democrats considered other bills in 2009 that explicitly did authorize subsidies in federal exchanges. But they discarded that language in favor of the ACA’s approach.
- More than a dozen Senate Democrats championed a bill that explicitly conditioned exchange subsidies on states implementing that bill’s employer mandate. Those senators discarded that condition in favor of the ACA’s approach of explicitly conditioning premium subsidies on states implementing exchanges.
- Eleven House Democrats from Texas recognized and even complained that states could prevent their residents from receiving “any benefit” under the ACA, including premium subsidies, simply by refusing to establish exchanges. In early January 2010, they pleaded for House Speaker Nancy Pelosi and President Barack Obama to support one of the bills that explicitly authorized subsidies in federal exchanges. Yet all 11 of them ended up voting for the ACA, despite their reservations.
- One of the ACA’s architects and a paid consultant to the Obama administration, Massachusetts Institute of Technology health economist Jonathan Gruber, repeatedly described the ACA by saying: “If you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits.”