CBO director says it was 'common understanding' federal subsidies apply to all states

Doug Elmendorf, director of the nonpartisan Congressional Budget Office during the time the Patient Protection and Affordable Care Act was being drafted, said Tuesday it was "common understanding" that subsidies for health insurance would be available to people in all states, according to The Hill.

In the ongoing Supreme Court battle of King v. Burwell, challengers claim the language of the law stipulates subsidies are reserved for residents in states that have established their own exchanges, as opposed to the federal marketplace exchange. A ruling in the case is expected by the end of June.

Mr. Elmendorf told The Hill the notion that subsidies would only be available in states with their own exchanges was never discussed at the time of the drafting of the PPACA.

"It was a common understanding on the Hill, again on both sides of the Hill, on both sides of the aisle, in late 2009 and early 2010, that subsidies would be available through the federal exchange as well as through state exchanges," Mr. Elmendorf said in an interview at the Peterson Foundation fiscal summit, according to The Hill. "And I'm confident in saying that because CBO's analysis always worked under the view that subsidies would be available under the federal exchange." 

The assumption that the subsidies would be available on both state and federal exchanges was never questioned while the CBO worked on estimating the cost projections for the law, according to Mr. Elmendorf. "Our analysis was subject to a lot of very intense scrutiny and a lot of questions, and my colleagues and I could remember no occasion on which anybody asked why we were expecting subsidies to be paid in all states regardless of whether they established their exchanges or not," he said. "And if people had not had this common understanding about what the law was going to do at that time, I'm sure we would have had a lot of questions about that aspect of our estimates."

Despite Mr. Elmendorf's defense of the intended interpretation of the law, the Supreme Court justices vary in how much they weigh congressional intent in determining the legality of the subsidies. According to The Hill, the more conservative justices are more inclined to base their decision on the plain text of the law, which challengers purport limits subsidies to state-run exchanges.

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