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Yesterday the U.S. Court of Appeals for the D.C. Circuit ruled to weaken federal funding mandated by the Affordable Care Act, raising costs for millions of Americans who have gained health insurance since October 1, 2013.

Then the Fourth Circuit Court of Appeals, in Richmond, Va., ruled the opposite.

The courts deliberated on whether or not Americans who choose insurance in the federally operated Health Insurance Marketplace — rather than in state-run marketplaces, also called exchanges — could receive tax credits to subsidize the cost of their insurance. The D.C. Circuit found that the law’s language disqualified people in the 34 states with federally operated exchanges from receiving federal subsidies; the Fourth Circuit Court stated otherwise.

“I am pleased to join in full the majority’s holding that the Patient Protection and Affordable Care Act ‘permits’ the (IRS) to decide whether premium tax credits should be available to consumers who purchase health insurance coverage on federally-run Exchanges,” Senior Fourth Circuit Judge Andre Davis wrote in a concurring opinion. “But I am also persuaded that, even if one takes the view that the Act is not ambiguous in the manner and for the reasons described, the necessary outcome of this case is precisely the same.

“That is, I would hold that Congress has mandated in the Act that the IRS provide tax credits to all consumers regardless of whether the Exchange on which they purchased their health insurance coverage is a creature of the state or the federal bureaucracy.”

The rulings will not immediately affect 4.7 million Americans who gained coverage through the federal marketplace, housed online at, but the disagreements will likely be settled in the Supreme Court. Data indicate that a decision agreeing with the D.C. Circuit Court would substantially impact the nation’s overall health, including:

White House Press Secretary Josh Earnest said in a statement, “Another partisan attempt to harm the Affordable Care Act failed today. This latest attempt was undermined by a unanimous judicial panel in the Fourth Circuit. The law was designed to make health care affordable through tax credits — and it is working.”