What was the central legal question in King v. Burwell?

In King v. Burwell, the central legal question was one of legislative interpretation rather than a constitutional challenge to the Patient Protection and Affordable Care Act (ACA).1

Specifically, the Court had to determine whether the ACA permitted the Internal Revenue Service to issue tax credit subsidies to consumers who purchased health insurance on a federal exchange, or if those subsidies were restricted exclusively to consumers using state-run exchanges.1

The plaintiffs argued that the statutory language referring to an "Exchange established by the State" precluded the issuance of subsidies for insurance purchased on federal exchanges. Conversely, the government contended that the federal exchange functioned as a stand-in for state exchanges, making subsidies permissible in all states. The Supreme Court ultimately ruled that the statutory scheme compelled a broader interpretation, as the narrower reading would have destabilized the individual insurance market and undermined the law's core purpose.1