What was at stake in King v. Burwell?

DH: Perhaps more than initially meets the eye. If the U.S. Supreme Court had sided with the King v. Burwell plaintiffs, federal tax subsidies to reduce the cost of insurance premiums would have been lost to low and moderate income Americans residing in the 34 states in which the federally-run health insurance exchange is operating, forcing many to drop coverage. Moreover, if the plaintiffs in King v. Burwell secured the relief they were seeking, then, in the 34 federal exchange states, the individual coverage mandate would have been significantly weakened and the employer “pay or play” provisions would have been rendered unenforceable. Without these key underpinnings, the ACA might have slowly crumbled under the weight of rising insurance premiums from health insurers.

How did intent figure into the Supreme Court’s ruling?

DS: The Chief Justice stated in his conclusion that “a fair reading of legislation demands a fair understanding of the legislative plan.” After reviewing the vague or contradictory provisions of the ACA, the Chief Justice focused on the intent of Congress in interpreting the law as a whole and concluded: “Congress passed the ACA to improve markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”