King v. Comm'r

Decision Date22 July 2014
Docket NumberNo. 14–1158.,14–1158.
CourtU.S. Court of Appeals — Fourth Circuit
PartiesDavid KING; Douglas Hurst; Brenda Levy; Rose Luck, Plaintiffs–Appellants, v. Sylvia Matthews BURWELL, in her official capacity as U.S. Secretary of Health and Human Services; United States Department of Health & Human Services; Jacob Lew, in his official capacity as U.S. Secretary of the Treasury; United States Department of the Treasury; Internal Revenue Service; John Koskinen, in his official capacity as Commissioner of Internal Revenue, Defendants–Appellees. Senator John Cornyn; Senator Ted Cruz; Senator Orrin Hatch; Senator Mike Lee; Senator Rob Portman; Senator Marco Rubio; Congressman Darrell Issa; Pacific Research Institute; The Cato Institute; The American Civil Rights Union; Jonathan H. Adler; Michael F. Cannon; State of Oklahoma; State of Alabama; State of Georgia; State of West Virginia; State of Nebraska; State of South Carolina; Consumers' Research; State of Kansas; The Galen Institute, Amici Supporting Appellants. Commonwealth of Virginia; America's Health Insurance Plans; American Cancer Society; American Cancer Society Cancer Action Network; American Diabetes Association; American Heart Association; Public Health Deans, Chairs, And Faculty; Members of Congress And State Legislatures; American Hospital Association; Economic Scholars; Families USA; AARP; National Health Law Program, Amici Supporting Appellees.

759 F.3d 358

David KING; Douglas Hurst; Brenda Levy; Rose Luck, Plaintiffs–Appellants,
v.
Sylvia Matthews BURWELL, in her official capacity as U.S. Secretary of Health and Human Services; United States Department of Health & Human Services; Jacob Lew, in his official capacity as U.S. Secretary of the Treasury; United States Department of the Treasury; Internal Revenue Service; John Koskinen, in his official capacity as Commissioner of Internal Revenue, Defendants–Appellees.

Senator John Cornyn; Senator Ted Cruz; Senator Orrin Hatch; Senator Mike Lee; Senator Rob Portman; Senator Marco Rubio; Congressman Darrell Issa; Pacific Research Institute; The Cato Institute; The American Civil Rights Union; Jonathan H. Adler; Michael F. Cannon; State of Oklahoma; State of Alabama; State of Georgia; State of West Virginia; State of Nebraska; State of South Carolina; Consumers' Research; State of Kansas; The Galen Institute, Amici Supporting Appellants.

Commonwealth of Virginia; America's Health Insurance Plans; American Cancer Society; American Cancer Society Cancer Action Network; American Diabetes Association; American Heart Association; Public Health Deans, Chairs, And Faculty; Members of Congress And State Legislatures; American Hospital Association; Economic Scholars; Families USA; AARP; National Health Law Program, Amici Supporting Appellees.

No. 14–1158.

United States Court of Appeals,
Fourth Circuit.

Argued: May 14, 2014.
Decided: July 22, 2014.


[759 F.3d 362]


ARGUED:Michael Anthony Carvin, Jones Day, Washington, D.C., for Appellants.
Stuart F. Delery, United States Department of Justice, Washington, D.C., for Appellees. Stuart Alan Raphael, Office of the Attorney General of Virginia, Richmond, Virginia, for Amicus Commonwealth of Virginia. ON BRIEF:Yaakov M. Roth, Jonathan Berry, Jones Day, Washington, D.C., for Appellants. Dana J. Boente, United States Attorney, Office of the United States Attorney, Alexandria, Virginia; Beth S. Brinkmann, Deputy Assistant Attorney General, Mark B. Stern, Alisa B. Klein, Civil Division, United States Department of Justice, Washington, D.C., for Appellees. Michael E. Rosman, Center for Individual Rights, Washington, D.C.; Carrie Severino, The Judicial Education Project, Washington, D.C.; Charles J. Cooper, David H. Thompson, Howard C. Nielson, Jr., Brian W. Barnes, Cooper & Kirk, PLLC, for Amici Senator John Cornyn, Senator Ted Cruz, Senator Orrin Hatch, Senator Mike Lee, Senator Rob Portman, Senator Marco Rubio, and Congressman Darrell Issa. C. Dean McGrath, Jr., McGrath & Associates, Washington, D.C.; Ilya Shapiro, Cato Institute, Washington, D.C.; Bert W. Rein, William S. Consovoy, J. Michael Connolly, Wiley Rein LLP, Washington, D.C., for Amici Pacific Research Institute, The Cato Institute, and The American Civil Rights Union. Andrew M. Grossman, Baker Hostetler, Washington, D.C., for Amici Jonathan H. Adler and Michael F. Cannon. E. Scott Pruitt, Attorney General, Patrick R. Wyrick, Solicitor General, Office of the Attorney General of Oklahoma, Oklahoma City, Oklahoma; Luther Strange, Attorney General, Office of the Attorney General of Alabama, Montgomery, Alabama; Sam Olens, Attorney General, Office of the Attorney General of Georgia, Atlanta, Georgia; Patrick Morrisey, Attorney General, Office of the Attorney General of West Virginia, Charleston, West Virginia; Jon Bruning, Attorney General, Katie Spohn, Deputy Attorney General, Office of the Attorney General of Nebraska, Lincoln, Nebraska; Alan Wilson, Attorney General, Office of the Attorney General of South Carolina, Columbia, South Carolina, for Amici State of Oklahoma, State of Alabama, State of Georgia, State of West Virginia, State of Nebraska, and State of South Carolina. Rebecca A. Beynon, Kellogg, Huber, Hansen, Todd, Evans & Figel, P.L.L.C., Washington, D.C., for Amicus Consumers' Research. Derek Schmidt, Attorney General, Jeffrey A. Chanay, Deputy Attorney General, Stephen R. McAllister, Solicitor General, Bryan C. Clark, Assistant Solicitor General, Office of the Attorney General of Kansas, Topeka, Kansas; Jon Bruning, Attorney General, Office of the Attorney General of Nebraska, Lincoln, Nebraska, for Amici State of Kansas and State of Nebraska. C. Boyden Gray, Adam J. White, Adam R.F. Gustafson, Boyden Gray & Associates, Washington, D.C., for Amicus The Galen Institute. Mark R. Herring, Attorney General,

[759 F.3d 363]

Cynthia E. Hudson, Chief Deputy Attorney General, Trevor S. Cox, Deputy Solicitor General, Office of the Attorney General of Virginia, Richmond, Virginia, for Amicus Commonwealth of Virginia. Joseph Miller, Julie Simon Miller, America's Health Insurance Plans, Washington, D.C.; Andrew J. Pincus, Brian D. Netter, Mayer Brown LLP, Washington, D.C., for Amicus America's Health Insurance Plans. Mary P. Rouvelas, American Cancer Society Cancer Action Network, Washington, D.C.; Brian G. Eberle, Sherman & Howard L.L.C., Denver, Colorado, for Amici American Cancer Society, American Cancer Society Cancer Action Network, American Diabetes Association, and American Heart Association. Clint A. Carpenter, H. Guy Collier, Ankur J. Goel, Cathy Z. Scheineson, Lauren A. D'Agostino, McDermott Will & Emery LLP, Washington, D.C., for Amicus Public Health Deans, Chairs, and Faculty. Elizabeth B. Wydra, Douglas T. Kendall, Simon Lazarus, Brianne J. Gorod, Constitutional Accountability Center, Washington, D.C., for Amicus Members of Congress and State Legislators. Melinda Reid Hatton, Maureen Mudron, American Hospital Association, Washington, D.C.; Dominic F. Perella, Sean Marotta, Hogan Lovells U.S. LLP, Washington, D.C., for Amicus American Hospital Association. Matthew S. Hellman, Matthew E. Price, Julie Straus Harris, Previn Warren, Jenner & Block LLP, Washington, D.C., for Amicus Economic Scholars. Robert N. Weiner, Michael Tye, Arnold & Porter LLP, Washington, D.C., for Amicus Families USA. Stuart R. Cohen, Michael Schuster, AARP Foundation Litigation, Washington, D.C.; Martha Jane Perkins, National Health Law Program, Carrboro, North Carolina, for Amici AARP and National Health Law Program.

Before GREGORY and THACKER, Circuit Judges, and DAVIS, Senior Circuit Judge.


Affirmed by published opinion.
Judge GREGORY wrote the opinion, in which Judge THACKER and Senior Judge DAVIS joined. Judge DAVIS wrote a concurring opinion.

GREGORY, Circuit Judge:

The plaintiffs-appellants bring this suit challenging the validity of an Internal Revenue Service (“IRS”) final rule implementing the premium tax credit provision of the Patient Protection and Affordable Care Act (the “ACA” or “Act”). The final rule interprets the ACA as authorizing the IRS to grant tax credits to individuals who purchase health insurance on both state-run insurance “Exchanges” and federally-facilitated “Exchanges” created and operated by the Department of Health and Human Services (“HHS”). The plaintiffs contend that the IRS's interpretation is contrary to the language of the statute, which, they assert, authorizes tax credits only for individuals who purchase insurance on state-run Exchanges. For reasons explained below, we find that the applicable statutory language is ambiguous and subject to multiple interpretations. Applying deference to the IRS's determination, however, we uphold the rule as a permissible exercise of the agency's discretion. We thus affirm the judgment of the district court.

I.

In March of 2010, Congress passed the ACA to “increase the number of Americans covered by health insurance and decrease the cost of health care.” Nat'l Fed'n of Indep. Bus. v. Sebelius, ––– U.S. ––––, 132 S.Ct. 2566, 2580, 183 L.Ed.2d 450 (2012) ( NFIB ). To increase the availability of affordable insurance plans, the Act provides for the establishment of “Exchanges,” through which individuals can purchase competitively-priced health care coverage. See ACA §§ 1311, 1321. Critically, the Act provides a federal tax credit

[759 F.3d 364]

to millions of low- and middle-income Americans to offset the cost of insurance policies purchased on the Exchanges. See26 U.S.C. § 36B. The Exchanges facilitate this process by advancing an individual's eligible tax credit dollars directly to health insurance providers as a means of reducing the upfront cost of plans to consumers.

Section 1311 of the Act provides that “[e]ach State shall, not later than January 1, 2014, establish an American Health Benefit Exchange.” ACA § 1311(b)(1). However, § 1321 of the Act clarifies that a state may “elect” to establish an Exchange. Section 1321(c) further provides that if a state does not “elect” to establish an Exchange by January 1, 2014, or fails to meet certain federal requirements for the Exchanges, “the Secretary [of HHS] shall ... establish and operate such exchange within the State....” ACA § 1321(c)(1). Only sixteen states plus the District of Columbia have elected to set up their own Exchanges; the remaining thirty-four states rely on federally-facilitated Exchanges.

Eligibility for the premium tax credits is calculated according to 26 U.S.C. § 36B. This section defines the annual “premium assistance credit amount” as the sum of the monthly premium assistance amounts for “all coverage months of the taxpayer occurring during the taxable year.” Id. § 36B(b)(1). A “coverage month” is one in which the taxpayer is enrolled in a health plan “through an Exchange established by the State under section 1311.” Id. § 36B(c)(2)(A)(i); see also id. § 36B(b)(2)(A)-(B) (calculating the premium assistance amount in relation to the price of premiums available and enrolled in “through an Exchange established by the State under [§ ] 1311”).

In addition to the tax credits, the Act requires most Americans to obtain “minimum essential” coverage or pay a tax penalty imposed by the IRS. Id. § 5000A; NFIB, 132 S.Ct. at 2580. However, the Act includes an unaffordability exemption that excuses low-income individuals for whom the annual cost of health coverage exceeds eight percent of their...

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