King v. Burwell: If "broader context" is meaningless, then the DC exchange is screwed as well

The whole fuss and bother at the heart of the King v. Burwell case centers around this subsection of the Patient Protection and Affordable Care Act:

(2) (a) the monthly premiums for such month for 1 or more qualified health plans offered in the individual market within a State which cover the taxpayer, the taxpayer's spouse, or any dependent (as defined in section 152) of the taxpayer and which were enrolled in through an Exchange established by the State under 1311 [1] of the Patient Protection and Affordable Care Act

The short version of the plaintiff's argument, of course, is that supposedly this means that federal tax credits are kosher for individual states which "established" their own exchanges (16 states plus the District of Columbia) but not for the remaining 34 states, since they're being run by the federally-"established" exchange.

The government's defense, of course, is that there's like a half-dozen other places throughout the law which make it pretty damned clear that tax credits should be kosher for states run through the federal exchange as well:

(1) IMMEDIATE ESTABLISHMENT.—Not later than July 1, 2010, the Secretary, in consultation with the States, shall establish a mechanism, including an Internet website, through which a resident of any State may identify affordable health insurance coverage options in that State.

(c) FAILURE TO ESTABLISH EXCHANGE OR IMPLEMENT REQUIREMENTS.— (1) IN GENERAL.—If— (A) a State is not an electing State under subsection (b); or (B) the Secretary determines, on or before January 1, 2013, that an electing State— (i) will not have any required Exchange operational by January 1, 2014; or (ii) has not taken the actions the Secretary determines necessary to implement— (I) the other requirements set forth in the standards under subsection (a); or (II) the requirements set forth in subtitles A and C and the amendments made by such subtitles; the Secretary shall (directly or through agreement with a not-for-profit entity) establish and operate such Exchange within the State and the Secretary shall take such actions as are necessary to implement such other requirements.

...and so on.

The King plaintiffs are trying to say that none of that matters. There could be 100 other places where Healthcare.Gov is good to go for everything, but since it doesn't specifically say "the IRS can also dole out tax credits for those enrolled via the federally-established exchange" within the particular subsection in question, tough patooties.

In short, the King v. Burwell case comes down to whether the law should be interpreted purely based on the verbatim wording of that particular sentence or whether it should be read in the broader context of the rest of the law.

Here's the thing, though: You'll notice that I defined "individual states which "established" their own exchanges" as "16 states plus the District of Columbia" above.

Yet as anyone with a 1st Grade education knows, the District of Columbia is most certainly not a "state". It's a District.

The U.S. Constitution provided for a federal district under the exclusive jurisdiction of the Congress and the District is therefore not a part of any U.S. state.

The states of Maryland and Virginia each donated land to form the federal district, which included the pre-existing settlements of Georgetown and Alexandria.

Fortunately, in section 1304 of the Patient Protection and Affordable Care Act, "Related Definitions", subsection (d), can be found the following:

(d) STATE.—In this title, the term ‘‘State’’ means each of the 50 States and the District of Columbia.

WHEW!! Thank goodness for that!

If that broader context explanation of what the word "State" wasn't included elsewhere in the ACA, then not only would an additional 20,000 or so people be SOL when it comes to federal tax subsidies, they wouldn't even be allowed to enroll in their policies at full price, since the exchange itself wouldn't have been legally authorized! In addition, the 67,000 or so Medicaid expansion recipients would be invalid as well!

In fact, those 16,000 or so enrollees in the DC SHOP exchange--which happens to mostly consist of Congressional staffers and--imagine that--members of Congress itself!--would also find themselves uninsured as well!

Fortunately for the members of the U.S. Congress and their staff members, there's this thing called "broader context" which allows you to include other parts of the law when considering what a given section actually means.