Adler Jonathan H, Cannon Michael F
Case Western Reserve University School of Law, USA
Health Matrix Clevel. 2013 Spring;23(1):119-95.
The Patient Protection and Affordable Care Act (PPACA) provides tax credits and subsidies for the purchase of qualifying health insurance plans on state-run insurance exchanges. Contrary to expectations, many states are refusing or otherwise failing to create such exchanges. An Internal Revenue Service (IRS) rule purports to extend these tax credits and subsidies to the purchase of health insurance in federal exchanges created in states without exchanges of their own. This rule lacks statutory authority. The text, structure, and history of the Act show that tax credits and subsidies are not available in federally run exchanges. The IRS rule is contrary to congressional intent and cannot be justified on other legal grounds. Because tax credit eligibility can trigger penalties on employers and individuals, affected parties are likely to have standing to challenge the IRS rule in court.
《患者保护与平价医疗法案》（PPACA）为在州立保险交易所购买符合条件的医疗保险计划提供税收抵免和补贴。与预期相反，许多州拒绝或以其他方式未能设立此类交易所。美国国税局（IRS）的一项规定旨在将这些税收抵免和补贴扩展至在没有本州交易所的情况下设立的联邦交易所购买医疗保险。该规定缺乏法定授权。该法案的文本、结构和历史表明，联邦运营的交易所无法获得税收抵免和补贴。美国国税局的规定与国会意图相悖，且无法基于其他法律理由得到正当辩护。由于税收抵免资格可能引发对雇主和个人的处罚，受影响的各方可能有资格在法庭上质疑美国国税局的规定。
