decide whether my state should establish an exchange, and i wanted to know whether individuals who enrolled in a plan on my possible state-established exchange would get a credit, where would i look? >> exactly. the basic thesis here is these exchanges don't work without subsidies. you've read 1311. you've read 1321. now you're going to go find out where the subsidies are. that's 36b. they're hypothesizing state -- >> i think not, mr. carvin. i mean, i think the place i would look to find out about my choices is in the provision of the statute that talks about my choices. i think the last place i would look is a provision of the statute that talks about what is it coverage months for purposes of this subsection, which, by the way, isn't even the right subsection, but whatever. [laughter]

that's where i would look, is in where it talks about what a coverage month is? >> but, your honor, i've already described the difficulties of putting it part of it in 1321, right? because then you would create this bizarre tax credit provision which is only half true, and you wouldn't tell taxpayers and insurance companies. so i believe that's the complete answer. but the other practical point i'd like to make is they had three years to implement this. and no one thought the states were going to have to make a decision overnight. if the irs had done its job, every state would have been fully informed of the consequences because presumably they've read 36b, and then they would make an intelligent decision well in advance of the two 2013 deadline. so there's a bizarre notion that states were somehow unable to read a statute or to or to read a regulation is simply -- >> i really want i really want to hear what you're going to say in your two minutes. -- 5 to 10 minutes.

and if you want, only if you want, i would be interested in your responses to the government's brief, that if you read the words "established by the state" without reference to the technical definition as you wish, this isn't just about the taxes. it means employers in virginia don't have to make policy, don't have to don't have to give policies, but if they have one maryland worker they do. it means that they never can tighten up their medicaid regulations, never, in 34 states but, of course, in the others they can. it means that there's no qualified person ever to buy anything on a an exchange established by the secretary for the state, and they have two or three other anomalies that have nothing to do with taxes, all of which supports their argument that you have to read this phrase technically according to the definition. now, that's their basic point. i've tried to summarize it. do it as you wish you. i just want you to have 5 or 10 minutes to answer it. >> thank you. and the first point is there are no anomalies. >> i'm going to clock that, see if see if you get 5 minutes.

>> there are no the first point i'd like to make is there are no anomalies stemming from our interpretation of 36b. the government agrees with that. their biggest anomaly is this qualified individuals point about how there would be nobody on hhs exchanges. the solicitor general is not going to stand up here and tell you that if we prevail in our interpretation of 36b, they would be obliged by the logic of that opinion to empty out hhs exchanges. so we all agree that there's no connection between 36b and the qualified individual. that's point one. point two is, if you want anomalies, their interpretation of the statute requires 34 states today to lose all medicaid coverage. why is that? because of the provisions on 64a through 66a of the government's brief, there are various requirements that the state, on pain of losing all of its medicaid funds, must coordinate between the state-established exchange, the state agency for

chip, and the state agency for medicaid in terms of secure interface and enrollment. now that makes perfect sense if "exchange established by the state" means what it says, but they think it encompasses hhs exchanges. well, the state cannot ensure coordination between hhs exchanges and the state agencies, and none of the 34 are doing it today. so under their atextual reading of the statute, 34 states will suffer the penalty that this court found in nfib as unconstitutionally coercive. as to this medicaid maintenance anomaly, the government agrees that the purpose of this provision was to freeze medicaid payments until you had an exchange with subsidies, which makes sense, right? you want to coordinate the two. and that's exactly what this provision means under our interpretation. until you have an exchange with subsidies, the states will be frozen. the government says, that thing ended on january 1, 2014. that's a figment of their imagination. it's nowhere in the statute. plus which it makes no sense.

before 2014, the states were powerless to have an exchange with subsidies right? they couldn't do it. so there was a 3year freeze on medicaid that they were powerless to get out of. after 2014, if they don't want to have their medicaid frozen, all they have to do is establish an exchange. so it's a less harsh restriction on states, plus which it gives them another incentive in addition to the subsidies to create the state exchange, which is the purpose enunciated in 1311. i don't know oh, as to, yeah maybe somebody would from another if you had an employee that let lived in other state, maybe he would be subject to the employer mandate. why is that an anomaly? congress likes the employer mandate. of course they wanted to expand it. they also never thought it would really happen because, again, what they thought was going to happen was there wouldn't be neighboring states without it because nobody was going to turn down this extraordinarily

generous deal. i don't know if my 5 minutes are up, but that's my response to these anomalies. i think that you >> as i understand it -- >> i think if i could -- >> wow. you've been talking a long time. >> yes. yes. sorry. >> you have two more sentences. >> even if there were anomalies in these other sections, you don't transport them to 36b which is concededly neither absurd and furthers the purposes of the act, just like in utility air, because the word pollutants didn't work with one section, you don't spread it like a virus throughout the rest of the act. you cure it in that provision -- >> those were two long sentences -- [laughter] >> if and when there's any litigation. >> i think i think -- >> oh, it was a long sentence. >> yes. i think i'm right that justice breyer's question about anomalies, which are replete in the act, under your interpretation, did not talk about what i think is one of the most glaring ones, which is this qualified individualist thing, that you're essentially setting up a system in which these

federal exchanges, that there will be no customers and, in fact, there will be no products, because section 1311 says that the exchange shall make health plans available to qualified individuals, and then the next section says that qualified individual means an individual who resides in the state that established the exchange. so under your theory, if federal exchanges don't qualify as exchanges established by the state, that means federal exchanges have no customers. >> which, of course, is not the reading that the government's giving to it because they're not going to tell you -- >> well, that's because they don't share your theory. >> no, no. >> under your theory -- >> no. >> that's the result. >> well, no. let me be as clear as i can. if we prevail in this case, they are not going to empty out the hhs exchanges because they understand that there are numerous defenses even if you interpret "established by the state" literally in the qualified individuals provision. number one defense that they will use is, it says you have to be a qualified individual with respect to an exchange.

as justice breyer pointed out, the statutory definition of exchange is a 1311 exchange. so they're only talking about state exchanges, not these hhs exchanges, and it is in section 1312, which immediately follows 1311, before 1321. number two, "qualified individual" doesn't mean that means you're guaranteed access. it doesn't mean if you're not qualified, you're absolutely denied access. we know that from the illegal alien provision, which says illegal aliens are neither qualified individuals nor eligible for subsidies. >> ah, but look at the look at the prisoner provision, which says prisoners shouldn't be treated as qualified individuals. so under your theory, this statute effectively said that prisoners should be able to enroll on federal exchanges? that makes no sense. >> it makes perfect sense to say the states get a choice. think about somebody who's in prison in february, they're getting out in april, they've

got to buy insurance under the go to buy insurance under the individual mandate. so if you said nobody who's incarcerated can buy insurance that means they wouldn't be able to buy insurance during the relevant enrollment period. it makes perfect sense to give states the flexibility to say, as to those incarcerated principles, you can make them available for exchanges, but under illegal aliens we don't want to, which is why we are saying they are neither qualified nor eligible. even if justice even if you don't find that the most pristine logic to be applied to a statute, remember, we are interpreting these statutes to avoid an absurd result. and it's a basic principle of statutory construction that you will give a plausible, if not the most persuasive, reading to a statute to avoid the result. >> but we are interpreting a statute generally to make it make sense as a whole, right? we look at the whole text. we don't look at four words. we look at the whole text, the particular context, the more general context, try to make everything harmonious with everything else. i think you said, even at the very beginning of this argument

as we were going back and forth about my hypothetical, that, of course, context matters and context might make all the difference with respect to what those five words mean. and i think what we're suggesting is that, if you look at the entire text, it's pretty clear that you oughtn't to treat those five words in the way you are. >> i've given you the contextual points before. i think the key one that i'd like to convey to you, justice kagan, is section 1311. you say the statute must work harmoniously. if you provide a subsidies to hhs exchanges, you have essentially gutted section 1311's strong preference for state exchanges. what will happen is precisely what did happen under the irs rule, 2/3 of the states are saying no, we're not going to undertake this thankless task of running these exchanges with no incentives to do so. so yes, it what i have here in

terms of what the statute means is 36b quite clearly saying exchanges are available only on states. i have 1311 explaining why they limited subsidies to that. and there is no contrary legislative history at all. what do they have, an atextual reading of 36b, which they can't explain why anybody would have used those words if they wanted to convey exchanges, a rule that completely undermines the purposes of 1311 and no supporting legislative history. so under all the legal materials that this court normally used to discern what statute means, we clearly prevail. >> thank you, counsel. general verrilli, you'll have extra 10 minutes as well. >> thank you, mr. chief justice, and may it please the court, standing has been raised, so let me start by telling you where we stand on standing and then i'd appreciate the opportunity after that to summarize what i think are the two key points in this case.

now, with respect to standing, the question the case or controversy question turns on whether any of the four petitioners is liable for the tax penalty for 2014. now, this case was litigated in the district court in 2013 based on projections on the part of each of the four petitioners that they would earn a certain income in 2014. they filed declarations saying that. with respect to 2 of the 4, the projections were of their income were such that they would qualify for the unaffordability exception and they wouldn't have standing. with respect to the other two, their projections were such that they wouldn't qualify for the unaffordability exception and they would have standing. but those were projections in 2013 about their income in 2014. 2014 has now come and gone, and we know we don't know, but petitioners know whether any of the 4 have, in fact are, in fact, liable for the tax penalty and that will depend on whether their actual income in 2014 matched their projections. now, mr. carvin said there was fact-finding about this.

i'm afraid that's not correct. the petitioners the petitioners did file a motion for summary judgment, but the case was decided on the basis of the government's motion to dismiss before discovery and without any fact-finding. i'm assuming because mr. carvin has not said anything about the absence of a tax penalty, that at least, 1 of the 4 has and is, in fact, liable for a tax penalty, but that's the key standing question. now, with respect to the veterans point, your honor, if it is the case, as mr. carvin tells us, that mr. hurst was a veteran for only 10 months, then i think he's correct, he would not qualify for va health care because you generally have to serve two years. so that's where we are on standing. now, if i could turn to the merits. >> so are you saying one person does have standing? >> no, no. it will depend on whether as a factual matter 1 of the 4 has and is, in fact, liable for the tax penalty for 2014. and that's information that is not in the government's possession. it is in the possession of petitioners' counsel. and i should make one more point, with respect to 2015,

there were no projections, there's nothing in the record about the possible income of any of the petitioners for 2015, so there's really nothing that would establish a case of controversy for 2014. >> well, you're surely not raising a standing question with us here for the first time at oral argument, are you? >> well, mr. chief justice, as i said, that based on the projections, it was our understanding that at least 1 of the 4 would be liable for a tax penalty. the question of standing has been raised and i've tried to identify for the court what i think is the relevant question which is whether any one of the 4 has, in fact is, in fact, liable for a tax penalty because -- >> this is this is on a motion to dismiss, right? >> well, that's correct, your honor, but it does also go to this court's jurisdiction. because if none of the four is liable for a tax penalty for 2014, there just isn't the case or controversy.

none of them is liable, there's no there's no injury. and so i do think that's ultimately the relevant question here and with respect to standing. i don't think there's a question about veteran status, but i do think that's the relevant question. >> isn't the question before us as to standing whether the district court correctly held in the motion to dismiss context that there was standing? that may not be the end of the matter, but don't we have to isn't that what's before us? >> well, that may be yes. but then you and you might alternatively think about this as a question of mootness, i guess, in that, you know, based on the projection, there was a case or controversy, but if the projection didn't come to pass and none of the plaintiffs is liable for a tax penalty, then the case or controversy no longer exists. >> well, what are you suggesting? should we have a should we have a trial here? >> no, i'm not suggesting anything of the kinds. >> on this issue and find -- what the facts are? >> justice alito, i did not raise standing affirmatively the court raised it. and i'm just doing my best to let the court know what our position is on standing. >> well, you would you send it back then to the district court? >> well, i guess no. i guess what i've said is that mr. carvin hasn't suggested that

there's no plaintiff liable for a tax penalty. based on that, i'm inferring that at least one of the petitioners -- >> representation by him? >> and i'm not -- >> would you -- has standing. why wouldn't we accept a there's no reason not to if he if he makes a representation that at least one of the four is has was liable in 2014 and is liable in 2000 or will be liable in 2015 -- >> so i guess what i'm saying -- >> i mean, we know at least one of them won't because that's -- >> what i'm saying about that is i'm actually going to step further than that, justice sotomayor, given that there hasn't been i'm willing to accept the absence of a representation as an indication that there is a case or controversy here, and so that's why, mr. chief justice, we haven't raised standing and that's what it but i do think that the key question is whether one of the four is liable for a tax penalty. you have to have that to have a case or controversy in the case. if i could now, let me please turn to the merits that summarize what i think are the two key points. first, our reading follows directly from the text of the

act's applicable provisions and it's really the only way to make sense of section 36b and the rest of the act. textually, their reading produces an incoherent statute that doesn't work. and second, our reading is compelled by the act's structure and design. their reading forces hhs to establish rump exchanges that are doomed to fail. it makes a mockery of the statute's express status express textual promise of state flexibility. it precipitates the insurance market death spirals that the statutory findings specifically say the statute was designed to avoid, and of course it revokes the promise of affordable care for millions of americans. that cannot be the statute that congress intended. >> of course it could be. i mean it may not be the statute they intended. the question is whether it's the statute that they wrote. i mean, you know, there are no provisions in the statute that turn out to be ill 11 ill considered and ill conceived.

>> so it's not the statute that they wrote, and the reason it's not the statute that they wrote, i think i want to actually start, if i could, picking up i think on a variation of the hypothetical that justice kagan ask asked. in petitioners' brief they throw down the gauntlet with respect to a hypothetical about airports, and that a statute requires a state to construct an airport, it says the federal government shall construct such airport if the state doesn't, and no one would think that the federal government's airport was an airport constructed by the state. well, what i would say to that is that if those statutory provisions were conjoined with a provision that said airplanes may only land at airports constructed by the state, then you would conclude immediately that what that federally constructed airport qualifies as an airport constructed by the state, and the because otherwise the statute would make no sense. and the same exact thing is true here. >> there are no statutes that make no sense. >> this one makes sense. >> if that is the case, every statute must make sense and we will we will twist the words as necessary to make it make that can't be the rule.

>> that isn't the rule. but the rule -- >> of course not. >> is that you read -- that you don't read statutory provisions in isolation. you read them in context. the rule is that you read them in order to ensure that the statute operates as a harmonious whole. you read them so that you don't render the statutory provisions ineffective. you read them to promote -- >> where is that possible. >> you read -- >> i mean, you acknowledge that all of what you're saying only applies where there are alternative readings that are reasonable. you pick the one that will do all the things that you say. >> and there is there is -- >> but, but if it can only reasonably mean one thing, it will continue to mean that one thing even if it has untoward consequences for the rest of the statute. no? >> with respect to this statute, first, let me i want to make two points. first -- >> answer me in principle. i mean, is it not the case that if the only reasonable interpretation of a particular provision produces disastrous consequences in the rest of the statute, it nonetheless means what it says. is that true or not?

>> i think there are a couple of limitations on that principle. the first is if what you have is a situation in which the that creates conflict within a statutory scheme, then the court's got to do its best to try to harmonize and reconcile the provisions. and, secondly -- >> well, i disagree with that. you have a single case in which we have said the provision is not ambiguous, it means this thing, but, lord, that would make a terrible statute, so we will interpret it to mean something else. do you have one case where we've ever said that? >> i think i think brown & williamson is a good example of that. in brown & williamson, the court said, look, the definition of drug and drug delivery device would actually seem unambiguously to cover tobacco but when you read that provision in context, and considering the full scope of the regulatory regime, it can't possibly mean that. but let me let me actually work through the text here, because i do think i can show you that there's a quite reasonable reading of this statutory text

that allows you to affirm and requires you to affirm the government's position. >> but, general verrilli, before we get too immersed in a number of provisions of this, could you respond to a question that was asked during mr. carvin's argument. if we adopt petitioners' interpretation of this act, is it unconstitutionally coercive? >> so the here's what i would say about that, justice alito. i think that it would be certainly be a novel constitutional question, and i think that i'm not prepared to say to the court today that it is unconstitutional. it would be my duty to defend the statute and on the authority of new york v. united states, i think we would do so. but i don't think there's any doubt that it's a novel question, and if the court believes it's a serious question -- >> is it a i was going to say does novel mean difficult? >> because it does seem to me that if petitioners' argument is correct, this is just not a rational choice for the states to make and that they're being coerced.

>> so what i -- >> and that you then have to invoke the standard of constitutional avoidance. >> well, what i was going to say, justice kennedy, is to the extent the court believes that this is a serious constitutional question and this does rise to the level of something approaching coercion, then i do think the doctrine of constitutional avoidance becomes another very powerful reason to read the statutory text our way. because i do think and i do think with respect to the point that your honor's making remember, it's not just it's not just a situation in which there is onerous conditions, onerous consequences for state residents. it's also a profound problem of notice here, that, you know, if you read petitioners' if you take petitioners' reading of the statute, then the idea that states were given added -- you can't possibly justify this as adequate notice to the states. >> well, mr. general verrilli, let me ask you this about notice. we get lots and lots of amicus

briefs from states. and we got two amicus briefs from states here. 34 states, i think, is -- that's the number of states that declined to or failed to establish a state exchange? >> correct. >> now, if they were all caught off guard and they were upset about this, you would expect them to file an amicus brief telling us that. but actually, of the 34, only 6 of them signed the brief that was submitted by a number of states making that argument. 23 states, 23 jurisdictions submitted that brief. 17 of them are states that established state exchanges. only 6 of the states that didn't establish state exchanges signed that brief, how do you account for that? >> so, i guess i'd make two points about that, justice alito. first, you've got states there, states in both camps, all of whom told you that they didn't understand the statute that way. now, with respect to the other 8 states that filed the amicus

brief on the other side, i actually think there's quite an important point that goes to their understanding of what this act did. remember, this is an irs rule that we're talking about here, and the irs put out a notice of proposed rulemaking saying this is what we intend to do, and several of these states oklahoma, indiana, nebraska they filed rulemaking comments in that in that proceeding. and if you look at those rulemaking comments you will see that they address a number of issues, and they say nothing, nothing about the issue that's before the court now. so if they really understood the statute as denying subsidies in states that did not set up their own exchanges, that would have front and center in their rulemaking comments, but they said nothing about it and i think that tells you a good deal about where -- what everybody understood that this statute was -- >> well, there's another point on notice on this pennhurst argument that seems curious to me. usually when this argument comes up, a state has signed up for a federal program and then they say, oh, my gosh, we didn't realize what we had gotten ourselves into.

but here, it's not too late for a state to establish an exchange if we were to adopt petitioners' interpretation of the statute. so going forward, there would be no harm. >> well, let me address that directly, and then i'd like to make a broader point about statutory context in response. now directly, of course, i don't i don't think it's possible to say there would be no harm. the tax credits will be cut off immediately and you will have very significant, very adverse effects immediately for millions of people in many states in their insurance markets -- >> well, i said i've said going forward. >> and then -- >> after the current tax year. >> and then going -- >> would it not be possible if we were to adopt petitioners' interpretation of the statute to stay the mandate until the end of this tax year as we have done in other cases where we have adopted an interpretation of the constitutional or a statute that

would have very disruptive consequences such as the northern pipeline case. >> sure. northern pipeline is an example of doing that, and it will be up to the court to decide whether it has the authority to do that. i will say, this does seem different than northern pipeline to me, because this is about money going out of the federal treasury, which is a different scenario. but if the court obviously, if that's where the court is going and that's what the court thinks the proper disposition is, that would reduce the disruption. but what i think is another important point to make here just as a practical matter, the idea that a number of states all of these states or a significant number are going to be able to in the 6 months between when a decision in the this case would come out and when the new the new year for insurance purposes will begin we'll be able to set up exchanges, get them up, up and running and get all the approvals done i think is completely unrealistic. >> how long has it taken -- >> well, for just to give you an example of the current time line, justice ginsburg, the in order to be in order to have an exchange approved and insurance policies on the exchange ready for the 2016 year, those approvals have to occur by may of 2015. ok. so that gives you a sense of the of the time line that hhs is

operating under. >> what about what about congress? you really think congress is just going to sit there while all of these disastrous consequences ensue. i mean, how often have we come out with a decision such as the you know, the bankruptcy court decision? congress adjusts, enacts a statute that 16 that takes care of the problem. it happens all the time. why is that not going to happen here? >> well, this congress, your honor, i >> you know, i mean, of course theoretically of course, theoretically they could. >> i don't care what congress you're talking about. if the consequences are as disastrous as you say, so many million people without insurance and whatnot, yes, i think this congress would act. >> and but the relevant question and then i'm going to try to get back to the point i was trying to make in response to justice alito's question. the relevant question here is, what did the congress that enacted this statute in 2010 do?

did they really set up a system in which the states are subject to the kind of onerous situation that the petitioner claims? and i think there are three textual indications objective, textual indications that cannot possibly have been the statutory scheme that congress tried to set up. first is the existence of the federal exchanges. it would make no sense, no sense for congress to have provided for federal exchanges if, as mr. carvin suggests, the statutory design was supposed to result in every state establishing its exchange. second -- >> well, wouldn't it have been again, talking about federalism a mechanism for states to show that they had concerns about the wisdom and the workability of the act in the form that it was passed? >> so, justice kennedy, i think the federalism values are promoted by our interpretation because if that is, indeed, what a state thought, if a state really would have preferred that not to have the state government participate in the implementation of this act, for reasons that your honor

identified, the structure of the act that congress put in place and that we're advocating for today fully vindicates that concern. they can decide not to participate without having any adverse consequences visited upon the citizens of the state. and that's why our reading is the pro-federalism reading. it's their reading that seems to me that is the anti-federalism reading, and that's a powerful reason to reject it. and if i could go to the second statutory point, which is related to what we're talking about, justice kennedy, which is section 1321, says that this statute is designed to afford state flexibility. state flexibility. it would be an orwellian sense of the word "flexibility" to use it in the manner that petitioners say the statute uses it, because it's the polar opposite of flexibility. and the third point, seems to me, is the notice point, that if, indeed, the plan was, as mr.

carvin said, that every state was going to establish an exchange for itself and that would cure all of the massive statutory anomalies and textual anomalies and absurdities and impossibilities that his reading provides for, if that was really the plan, then the consequence for the states would be in neon lights in this statute. you would want to make absolutely sure that every state got the message. but instead what you have is a subclause in section 36b, which is a provision that addresses the eligibility of individual taxpayers for taxing purposes. >> this is not the most elegantly drafted statute. it was it was pushed through on expedited procedures and didn't have the kind of consideration by a conference committee, for example, that statutes usually do. what would be so surprising if among its other imperfections, there is the imperfection that what the states have to do is not obvious enough? it doesn't strike me as

inconceivable. >> so, justice scalia, i'm going to answer that question by talking about the legislative process, because i think it is quite relevant and i think it ought to be quite relevant even to you with respect to the question you just asked. the language here in 36b was not the product of some last-minute deal, it wasn't the product of scrambling at the end. the language that emerged here the statutory structure with the language of 36b about tax credits, the language that's in 1311, the language that's in 1321 was the product of the senate finance committee markup, which went on for weeks and weeks. it was a public it was a public hearing. it frankly, it was covered by c-span. you can go watch it on the c-span archives if you want to and you will see coming out of that the that the understanding, the clear understanding was with this statutory setup would result in subsidies being

available in every state. >> there were senators, were there not, who were opposed to having the federal government run the whole thing, because they thought that would lead to a single-payer system, which some people wanted. and the explanation for this provision is it prevents it prevents the the federalization of the entire thing. >> no. justice scalia, i -- >> that's certainly a plausible explanation -- >> no. >> as to why the provision is there. >> mr. carvin has floated that as an explanation and he and he suggests that it was senator ben nelson who required it. we there is absolutely no contemporaneous evidence, none whatsoever, that anybody thought that way, that the solution to the problem that your honor's identified is what congress did by having states have the option to set up their own exchanges with state-by-state federal fallbacks rather than a national system. senator nelson has made clear, he has stated that he had no intention of the kind. there's no contemporaneous evidence at all that anyone did. and i do and what mr. carvin has suggested is that this was the product of some deal to try to

get votes so the act could get passed. what i would suggest to your honor is that there is objective proof that is not true. the provisions in the act that were negotiated at the end to secure the necessary votes are in title x of the act. and if you look in the in the act, pages 833 to 924, that's title x. you can see all of the amendments. not a single one has anything to do with the statutory language before the court now. >> well, the puzzle that's created by your interpretation is this-- if congress did not want the phrase "established by the state" to mean what that would normally be taken to mean, why did they use that language? why didn't they use other formulations that appear elsewhere in the act? why didn't they say "established under the act"? why didn't they say "established within the state"?

why didn't they include a provision saying that an exchange established by hhs is a state exchange when they have a provision in there that does exactly that for the district of columbia and for the territories? it says that they are deemed to be states for purposes of this act. >> so -- >> so why would they do that? >> so, of course, the provision says doesn't say "established by the state" with a period after state. it says "established by the state under section 1311." and our position textually is and we think this is clearly the better reading of the text that by cross-referencing section 1311, effectively what congress is doing is saying that exchanges established through whatever mechanism, exchanges set up by the states themselves, exchanges set up by -- >> so you're saying that by cross-reference to 1311, they really mean 1311 and 1321? >> yes. well, let me and i do think that, and let me walk through why i think that's true.

>> all right. that seems to me to go in the wrong direction -- >> no, i think -- >> for your case -- >> i think -- >> not the right direction. >> no, i think it goes in the right direction, if you'll just ride with me for a little bit, justice kennedy, on this. >> well, before you before you get on to that, that your answer doesn't explain why "by the state" is in there. then why didn't they say "established under 1311"? >> well, so the second point is that wherever this provision appears in the act, "established by the state under section 1311," it's doing work. and the work it's doing is saying, what we're talking about is the specific exchange established in the specific state as opposed to general rules for exchanges. if you look at the medicaid maintenance of effort provision that it works the same way. >> well, why didn't they say "in the state"? that's the phrase you just used "in the state." why didn't they say "in the state"? >> because i suppose they could have, but it worked perfectly well this way. if you look at the qualified individual provision, it's clearly how they're using it with respect to the qualified individual provision. and with respect to that provision, it says a qualified individual is a person who is located who resides in the state that established the exchange. clearly, what they're talking

about is a geographical reference to the particular state. that's what's going on there and what's going on every time the statute uses that phrase. so it's doing that work, and that's why it's in there. but now if i could go back to your point, justice kennedy, it says, "established by the state under section 1311." section 1311(b)(1) says, "each state shall establish an american health benefits exchange for the state." it's not, as mr. carvin said, an urging that states do it. it says, "each state shall establish." now, we know that when congress used that language, "each state shall establish," it must have meant something more inclusive than each state government shall itself set up the exchange. we know that because congress is legislating against the backdrop of the tenth amendment, and so it couldn't impose that requirement. and we know that because of section 1321, because section 1321 provides the means by which the 1311(b)(1) requirement is satisfied. it will be satisfied by a state electing to meet the federal requirements for exchanges, or it can be satisfied in the event

that a state doesn't or tries but comes up short by hhs stepping in and establishing the exchange. >> so when the statute says, "each state shall establish," it really means the federal government shall establish if a state doesn't establish. >> i think the right way -- >> and if that were the correct interpretation, you wouldn't 1321 at all. >> so, no. i think the right way to think about this, justice alito, is that what's going on here is that the right place to focus, let me put it that way. the right place to focus here is not on the who, but on the what. on the thing that gets set up and whether it qualifies as an exchange established by the state, and these exchanges do qualify. and the reason they qualify is because they fulfill the requirement in section 1311(b)(1) that each state shall establish an exchange. and 1321 tells you that because it says to the hhs that when a when a state hasn't elected to meet the federal requirements,

hhs steps in, and what the hhs does is set up the required exchange. it says such exchange, which is referring to the immediately prior to the required exchange where the only exchange required in the act is an exchange under section 1311(b)(1). so it has to be that's that what hhs is doing under the plain text of the statute is fulfilling the requirement of the section 1311(b)(1) that each state establish an exchange, and for that reason we say it qualifies as an exchange established by the state. that's reinforced, as justice breyer suggested earlier, by the definition which says that an exchange is an exchange established under section 1311. 1311, again, has 1311(b)(1) which says each state shall establish an exchange. and it has to be that way because petitioners have conceded, and it's at page 22 of their brief, that an exchange that hhs sets up is supposed to be the same exchange that petitioners say function just like an exchange that the state sets up for itself.

>> well, you're putting a lot of weight on the on the one word, such, such exchange. such it seems to me the most unrealistic interpretation of "such" to mean the federal government shall establish a state exchange. rather, it seems to me "such" means an exchange for the state rather than an exchange of the state. how can the government federal government establish a state exchange. that is gobbledygook. you know, "such" must mean something different. >> it isn't gobbledygook, justice scalia. and i think about it and i go back to something that justice alito asked earlier. and that if the language of 36b were exactly the same as it is now, and the statute said in 1321 that an exchange set up set up by hhs shall qualify as an exchange established by the state for purposes of section 1311, you wouldn't change the language of 36b one iota, and that wouldn't be any doubt in

anyone's mind that the that subsidies were available on federal exchanges. and what we're saying is that effectively reading 1311 and 1321 together, that is what the statute does. and that is certainly that is a reasonable reading of the statute. it is really the only reading of the statute that allows you to be faithful to the text of 1311(b)(1) the word "shall," and to the tenth amendment. in order for their -- >> the word "such" means not just the exchange that the state was supposed to set up, but it means the state exchange. >> it means an exchange that qualifies as satisfy as an exchange established by the state because it satisfies the requirement of 1311(b)(1). >> no. you have to say it means the state exchange. you have to your case hinges on the fact that a federal exchange is a state exchange for purposes --

>> it hinges on it hinges on it qualifying as the state exchange or being equivalent to the state exchange for the purpose of the operation of the statute. that is a reasonable reading of the particular textual provisions, and once you've concluded that it's a reasonable reading of the particular textual provisions, then you have to read it the way that we say it needs it is to be read because it is the only way to make sense of the statute as a whole. it is the only way to bring it into harmony with the act's qualified individual and qualified health plan provisions which do lead to what they admit is an absurdity under their reading under the law. >> would you agree that there that there are provisions of the act where the exact same phrase, "established by the state," has to be read to mean established by the state and not by hhs? >> i don't -- >> there are some provisions like that. >> they've pointed out some, but i think they're wrong about each one, and i don't know what your honor has in mind. >> all right. well, let's take one let's take one. i'd be interested in your answer to it. 42 u.s.c. section 1396w3( h)(1)(d) which says that each state shall

establish procedures to ensure that an exchange established by the state utilizes a secure electronic interface. and they say that if that is read to if "exchange established by the state" there is read to mean an hhs exchange, that means that the state in which that exchange is established is responsible for making sure that the federal exchange has a secure electronic interface. >> yes. they're just wrong about that. it's just completely wrong. the statute says that the state shall first of all, the statutory obligation is addressed to the state medicaid and chip agencies. what it says is they shall establish procedures to ensure the coordination. hhs has issued regulations setting forth what that statutory provision requires of states in those circumstance. every state where there is a federally facilitated exchange has met the requirements and fulfilled them, and it worked perfectly fine. there's no anomaly there at all. >> and the state -- >> it met it met the requirements of the regulations you say, but do the regulations track the statute?

>> yes, they do. >> do they give the state authority to say whether or not these these conditions have been met? >> they the requirements are imposed on the state medicaid and chip end of the relationship. that's what the statute does, and the regulation to implement that statutory requirement, and it's satisfied in every state. and, of course, as your honor reading it to me said, it does say and i think that proves our point. the statute says each state shall. it doesn't say states that have set up exchanges for themselves shall. it says each state shall. it presupposes that there is going to be something that qualifies as an exchange established by the state in every state. so there's no anomaly there, and if your honor wants to ask me about any of the other ones, you can, but i there are no anomalies frankly. >> as i understand your answer to be that there are federal regulations telling the states what they have to do here, and they've all done it. but the fact remains that the state has some obligation under the regulations to make sure that there is a proper interface with the federal exchange.

>> on the state's side of the interface, yes. but that's the chip and medicaid agencies. those are state government agencies, and it's their side of the interface that the statute governs. and, you know, as i said, i don't think there are anomalies of our reading, but if they are, they pale in comparison to the anomalies on the other side. i mean, i really do want to focus on this point about the qualified health plan and the qualified individual, because the statute is quite clear in section 1311 that an exchange, not an exchange established by the state, but an exchange can only sell a qualified health plan. it is forbidden from selling a health plan that is not a qualified health plan. and that's not an exchange established by the state. it is an exchange. now, the statute also says that to certify a health plan as qualified, the exchange has to decide that it is in the interest of qualified individuals. now, qualified individuals are persons who reside in the state that established the exchange. so if you read the statute, the language, the way mr. carvin reads it instead of the way we read it, you come to the conclusion and in a state in a federally facilitated exchange there are no qualified individuals.

therefore, the exchange cannot certify a qualified health plan as being in the interest of qualified individuals because there aren't any, so there aren't any qualified health plans that can lawfully be sold on the exchange. >> what is the provision that says that only a only a qualified individual can be can enroll in a plan under an exchange? >> so let the i will address that, but i just want to make clear the provision i'm talking about with respect to the prohibition on selling a qualified health plan to anybody on anything other than a qualified health plan on an exchange is 1311(d)(2)(b), which is at page 8a of the appendix to our brief. it's absolutely unambiguous. an exchange, not an exchange established by the state, an exchange may not make available any health plan that is not a qualified health plan.

so -- >> qualified health plan. but what's the provision you were referring to when you said that an exchange may enroll only a qualified individual? >> well, i what they 20 what the statute says throughout is that qualified individuals are eligible to purchase on exchanges, and it's the necessary meaning of that phrase that if you are not a qualified individual, then you are not eligible to purchase health care on an exchange because otherwise, the word qualified would not have any meaning. the whole the meaning of the word qualified is to distinguish between people who are eligible and people who are ineligible. and as a policy matter, it wouldn't make any sense because think of the people who are not qualified individuals. the people who don't live in the state, the people in prison, and they're unlawfully documented. >> this is part of section 1312. a person qualified to purchase on an exchange must, quote reside in the state that established the exchange. >> right. and there are no such people in 34 states under mr. carvin's theory of the statute.

so it just doesn't it just you just run into a textual brick wall. >> i understand your argument is that it's a it's a logical inference from a number of provisions that only a qualified individual may purchase the policy, but i gather there is no provision that you can point to that says that directly. >> it's well, that's what qualified means, justice alito. it means that, you know, if you're not qualified, you're unqualified. and so, i mean, that's what it means. and so you're just reading the word "qualified" out of the statute if you read it that way. >> "qualified" is used in the in the lay sense of the term, it's not a technical term here. >> well, i think -- well, given the way it's defined, it's defined as a person who resides in the state. it excludes people out of state. it does that because the statute was quite clear that you weren't going to be allowed to shop for insurance policies across state lines because that would infringe on traditional state prerogatives regulating insurance. and it and with respect to prisoners, it doesn't make any sense to say that prisoners should be able to get insurance. mr. carvin says, yes, it does because they get out of prison. well, there's a specific statutory provision that says

when you face a changed-life circumstance, such as getting out of prison, you can sign up for insurance at that point. he makes the point about unlawfully present persons being both unqualified and not being able to be covered, but that's not that's not surplus, that's there for a very important reason, which is that someone can be in lawful status and, therefore, be eligible for health care, but then lose lawful status and at that point, they can no longer be covered. so, just none of that works for them. none of that works for them. and but to really, to get to the fundamental point here that both at the level of text, you have clear irresolvable conflicts so that the statute can't work if you read it mr. carvin's way. you have, at the level of text -- >> is that a synonym for ambiguity? >> i think so, exactly right justice scalia i mean, excuse me, justice kennedy that you have ambiguity there precisely because you have to you know this is a statute that's going to operate one way or the other. and the question is how it's going to operate.

and when you read it their way, you 16 >> well, if it's if it's ambiguous, then we think about chevron. but it seems to me a drastic step for us to say that the department of internal revenue and its director can make this call one way or the other when there are, what, billions of dollars of subsidies involved here? hundreds of millions? >> yes, there are billions of dollars of subsidies involved here. but two points about that -- >> and it seems to me our cases say that if the internal revenue service is going to allow deductions using these, that it has to be very, very clear. >> so -- >> and it seems to me a little odd that the director of internal revenue didn't identify this problem if it's ambiguous and advise congress it was. >> so a few points about that with respect to chevron deference. first, we do think chevron deference clearly supports the government here and i'll explain

why. but before you get to that, you can resolve and should resolve this statute and the statute's meaning in our favor even without resort to chevron deference. that's what the canon of reading a statute as a whole to make it work harmoniously directs you to do. it's what the very important principles of federalism that we've been describing here direct you to do. if you think there's a constitutional problem with the statute, it's what the doctrine of constitutional avoidance directs you to do. now, with respect to chevron section 36b(g) of the statute expressly delegates to the irs the specific authority to make any decisions necessary to implement section 36b. so you don't have any ambiguity. congress said the irs should do this. it is a big question, but as the court said in city of arlington two terms ago, chevron applies to big questions as well as small. your honor raised this point about the need for clarity in a tax deduction and irs in the statutory reading of tax

deductions, there is a learned treatise that describes that as a false notion. and it is certainly not consistent with this court's unanimous decision in mayo two terms ago that chevron applies to the tax code like anything else. and so -- >> if you're right about chevron, that would indicate that a subsequent administration could change that interpretation? >> i think a subsequent administration would need a very strong case under step two of the chevron analysis that was a reasonable judgment in view of the disruptive consequences. so as i said, i think you can resolve and should resolve this case because the statute really has to be read when taken as a whole to adopt the government's position. but i do take -- >> general -- >> if there are any if there are any tax attorneys in the in the courtroom today, i think probably they wrote down what you just said. when we get future tax cases the united states is going to argue that we should not read them to you know, there should be no presumption that a tax credit is provided by that statute.

>> you should you should read it according to its terms. and when you read this provision according to its terms and you read it in context and you read it against the background principles of federalism, you have to affirm the government's interpretation. thank you. >> thank you, general. four minutes, mr. carvin. >> thank you, mr. chief justice. very quickly on standing. mr. hurst would be subject to a penalty absent relief by this court for 2014. as i've discussed, both he and mrs. leevy, of course, would face the same principle for 2015. if the government is suggesting that their case has become moot because of changed circumstances, under cardinal chemical 508 u.s. 83, it's their burden to raise it, not ours to supplement the record. in terms of the anomaly, in terms of all the states losing 34 states losing their medicaid funds, the solicitor general greatly distorted the statute. it's printed at 64a of their exhibit. it says, "a state shall establish procedures," so the notion that hhs established them

is obviously contrary to that. it says, "the state will identify people to enroll on their exchanges." well, they can't enroll anybody on their exchanges if there are no such exchanges in the state. therefore, by the plain language, if you adopt the notion that "exchange established by the state" means established by hhs, all of them need to lose their medicaid funding. >> could i follow up on something the general ended with, which and justice kennedy referred to, which is the need to read subsidies limited. but so is in a limited way. but so is the need to ensure that exemptions from tax liability are read in a limited way. and under your reading, we're giving more exemptions to employers not to provide insurance, more exemptions to states and others or to individuals, how does that work?

i mean, you've got two competing -- >> no, no. you do get more exemptions for employers under our reading, but and the same principle applies. is it unambiguous? it's undisputed that one is unambiguous. >> well -- >> the dispute here is whether or not if they win under ambiguity, and they don't because the canon requires unambiguous statutes not to afford the tax credit. in terms of the employer mandate, i think that's very helpful in terms of justice kennedy's concern about federalism. under their view of the statute, the federal government gets to unilaterally impose on states there's an amicus from indiana describing this a requirement that states insure their own individuals. it implies the employer mandate to states. so their under their theory, the states are absolutely helpless to stop this federal intervention into their most basic personnel practices. whereas under our theory, they are able to say, no. so actually, the more intrusive view of the statute is theirs. in terms of the funding condition, head on, your honor

i think my short answer is as follows -- there's no way to view this statute as more coercive or harmful than the medicaid version of medicaid that was approved by this court in nfib and, indeed, the nfib dissenting opinion pointed to this provision as something that was an acceptable noncoercive alternative. but in all events, even if there's a constitutional doubt under a novel constitutional question, as justice scalia pointed out, there's no alternative reading of the statute that avoids that because either way, you're intruding on state sovereignty. in terms of the anomaly, in terms of qualified individuals as predicted, solicitor general did not come up here and tell you, yes, if we prevail here under this theory, they're going to have to empty out the hhs exchanges. nor did he even respond to my argument that with respect to an exchange under the definitional section only applies to state exchanges. so i think we can view this as a complete tendentious litigation position and not a serious

statutory interpretation. in terms of the qualified health plan that he discussed with you, justice alito, the complete answer to that is that is in 1311. 1311 only is talking about state established exchanges. it has no application to hhs exchanges, therefore, it can't possibly create an anomaly with respect to those hhs exchanges. >> thank you, counsel. the case is submitted. >> president obama will be in charleston, s.c. tomorrow, too. attend the funeral services for reverend pinckney, one of nine people who was shot and killed last week in charleston. coverage starts at 11:00 a.m. eastern on c-span. on c-span2, a has panel will investigate russian lunches.

-- lunches. >> here are some of our featured programs this weekend. saturday night at 8:00 eastern we will look at the government and culture of iran, its relationship with the u.s. and nuclear ambitions. sunday night profile interviews with two presidential candidates. first kentucky republican senator rand paul, and then vermont independent bernie sanders. on c-span two saturday night at 10:00 eastern, are -- authored nelson dennis on the history of puerto rico and the turbulent relationship with the united states. then, historian h w brands on ronald reagan. on american history tv on c-span3, saturday night, a little after 9:00 commemorating the 800 and in verse three of

the magna carta. -- anniversary of the magna carta. on the rights of liberty and property the limits on executive power. sunday night on american artifacts, the french sailing ship brought its representative general lafayette in 1782 america. we will hear from the replica crew and officials. get the complete schedule at c-span.org. [chanting]

>> up next, more reaction from outside the supreme court. after that, remarks from harry reid. then, majority leader mitch mcconnell. and then the supreme court targets for the case in king versus burwell. president obama reacted to the ruling, he was joined by the vice president in the white house rose garden.

president obama: good morning, everybody. have a seat. five years ago, after nearly a century of talk, decades of trying, a year of bipartisan debate, we finally declared that in america, health care is not a privilege for a few but a right for all. over those five years, as we've worked to implement the affordable care act, there have been successes and setbacks. the setbacks, i remember clearly. [laughter]

but as the dust has settled, there can be no doubt that this law is working. it has changed and in some cases saved american lives. it's set this country on a smarter, stronger course. and today, after more than 50 votes in congress to repeal or weaken this law, after a presidential election based in part on preserving or repealing this law, after multiple challenges to this law before the supreme court, the affordable care act is here to stay. this morning, the court upheld a critical part of this law. the part that made it easier for americans to afford health insurance regardless of where you live. if the partisan challenge to this law had succeeded, millions of americans would have had thousands of dollars' worth of tax credits taken from them. for many, insurance would have become unaffordable again. many would have become uninsured

again. ultimately, everyone's premiums could have gone up. america would have gone backwards. that's not what we do. that's not what america does. we move forward. so, today is a victory for hardworking americans all across this country whose lives will continue to become more secure in the changing economy because of this law. if you're a parent, you can keep your kids on your plan until they turn 26. something that has covered millions of young people so far. that's because of this law. if you're a senior, or an american with a disability, this law gives you discounts on your prescriptions. something that's saved nine million americans an average of $1,600 so far. if you're a woman, you can't be charged more than anybody else even if you've had cancer or if your husband had heart disease or just because you're a woman.

your insurer has to offer free preventive services like mammograms. they can't place annual or lifetime caps on your care because of this law. because of this law and because of today's decision, millions of americans who i hear from every single day will continue to receive the tax credits that have given about eight in 10 people who buy insurance on the new marketplaces the choice of health care plans that cost less than $100 a month. and when it comes to pre-existing conditions, someday our grandkids will ask us, if there was really a time when america discriminated against people who get sick, because that is something this law has ended for good. that affects everybody with health insurance, not just folks who got insurance through the affordable care act. all of america has protection it didn't have before.

as the law's provisions have gradually taken effect, more than 16 million uninsured americans have gained coverage so far. nearly one in three americans who was uninsured a few years ago is insured today. the uninsured rate in america is the lowest since we began to keep records. that is something we can all be proud of. meanwhile, the law has helped hold the price of health care to its slowest growth in 50 years. if your family gets insurance through your job, or you're not using the affordable care act, you're still paying about $1,800 less per year on average than you would be if we hadn't done anything. by one leading measure, what business owners pay out in wages and salaries is now, finally growing faster than what they spend on health insurance. that hasn't happened in 17 years.

and that's good for the workers. and it's good for the economy. the point is, this is not an abstract thing anymore. this is not a set of political talking points. this is reality. we can see how it is working , this law is working exactly as it's supposed to. in many ways this law is working better than we expected it to. for all the misinformation campaigns, all the doomsday predictions, all the talk of death panels and job disruption, for all the repeal attempts, this law is now helping tens of millions of americans, and they've told me that it has changed their lives for the better. i've had moms come up and say my son was able to see a doctor and get diagnosed and catch a tumor

early and he's alive today because of this law. this law is working. and it's going to keep doing just that. five years in, this is no longer about a law. this is not about the affordable care act. legislation or obamacare as a political football. this is health care in america. and unlike social security or medicare, a lot of americans still don't know what obamacare is beyond all the political noise in washington. across the country, there remain people who are directly benefiting from the law but don't even know it. and that's ok. there's no card that says obamacare when you enroll. but that is by design. for this has never been a

government takeover of health care, despite cries to the contrary. this reform remains what it's always been a set of fair rule -- fairer rules and tougher protections that have made health care in america more affordable, more obtainable and more about you. the consumer. the american people. it's working. with this case behind us, let's be clear. we've still got work to do to make health care in america even better. we'll keep working to provide consumers with all the tools you need to make informed choices about your care, and keep working to increase the use of preventive care that avoids bigger problems down the road. we'll keep working to boost the steadily improving quality of care in hospitals. bring down costs even lower. make the system work even better. already we've seen reductions

for example, in the number of readmissions in hospitals. that saves our society money, it saves families money, it makes people healthier. we're making progress. we've got to keep working to get more people covered. i'm going to work as hard as i can to convince more governors at state legislatures to take advantage of the law, put politics aside, expand medicare and cover their citizens. we've still got states out there that for political reasons are not covering millions of people that they could be covering, despite the fact that the federal government's picking up the tab. so, we've got more work to do. what we're not going to do unravel what's been woven into the fabric of america. my greatest hope is that rather than keep refighting battles

that have been settled again and again and again, i can work with republicans and democrats to move forward. let's join together and make health care in america even better. three generations ago we chose to end an era when seniors were left to languish in poverty. we passed social security and slowly it was woven into this fabric of america and made a difference in the lives of millions of people. two generations ago, we chose to end an age when americans in their golden years didn't have the guarantee of health care. medicare was passed. and it helped millions of people. this generation of americans chose to finish the job. to turn the page on the past when our citizens could be denied coverage just for being sick.

to close the books on a history where americans had no hope of finding decent health care and had to hang their chances on faith. we chose to write a new chapter where in a new economy americans are free to change their jobs or start a business chase a new idea, raise a family, free from fear. secure in the knowledge that affordable health care is there for us and always will be. and that if we get sick, we're not going to lose our home. that if we get sick, that we're going to be able to still look after our families. that's what america is, we look out for one another, we root for one another's success.

when we strive to do better and to be better than the generation that came before us and try to build something better for generations to come. that's why we do what we do. that's the whole point of public service. so, this was a good day for america. let's get back to work. [applause]

>> next, reaction from outside the supreme court. after the decision was announced, we will hear from proponents of the health care law, including the acting solicitor general. ron: my name is ron pollack, and i am the executive director of families usa. which is a national organization for health care consumers. and with me, is gwen jackson from texas. who is one of the millions of people who are receiving the subsidies that were upheld today by the supreme court. make no mistake about this today's decision has monumental significance. it means that the affordable care act is not just the law of the land, it will remain the law of the land. gwen: yes!

ron: it means that the millions of people who have been receiving subsidies that make all the difference in terms of whether health insurance is affordable, people will continue to receive those subsidies, and they will continue to have health insurance. so, this is a big sigh of relief for millions of people across the country who previously were uninsured, who previously couldn't afford health insurance, but who today can afford insurance because they are receiving subsidies. and today, the court by a 6-3 margin upheld the provision of those subsidies. so, at this juncture, hopefully, now that the affordable care act is clearly a stable part of america's health care system hopefully, we can move on. hopefully, we can have bipartisan efforts to try to make even further improvements with respect to america's health care system, making sure

everyone has high-quality health care and at an affordable price. but most importantly, the affordable care act has produced enormous progress. more than one out of three people who were previously uninsured have now received health coverage. and now that progress will continue. we will not go backwards. and more and more people will be able to get the health coverage they need to protect their families. so, i want to introduce gwen jackson. gwen is from sugarland, texas. and gwen is one of the millions of people who are receiving the subsidies and whose subsidies will be protected. gwen: yes. so, thank you, ron. so, i am excited today. i'm excited. my husband and i are self-employed, both self-employed. and my husband had a severe

tumor that required surgery, and we were uninsured. but through the marketplace, my husband was able to get an extensive surgery, subsequently to get additional surgeries and may continue to have to have surgeries as a result of this. this was an aggressive bone disease of his jaw, and it impacted us greatly, but we are thankful today that the courts upheld this and realize that affordable care is not just for -- i don't know. it's for everybody, and it should be. it would have impacted over 6 million people, had they not agreed to this. but now, we don't have to worry about this anymore, and i just thank everyone that supported the act. gwen jackson.

ron: gwen jackson from sugarland, texas. gwen: g-w-e-n jackson. ron: ron, r-o-n, pollack, p like like peter o-l-l-a-c-k, with the national organization for health care consumers. i just want to say one additional thing. we have seen just extraordinary progress as a result of the affordable care act over the past two years. over 16 million people who were previously uninsured have gotten health coverage as a result of the affordable care act. and most of the people who have signed up in these marketplaces have done so as a result of subsidies, and these subsidies involve thousands of dollars in terms of relief, in terms of premium costs.

today, the supreme court clearly held by a 6-3 margin that those subsidyies will continue. the people having health insurance will be able to continue getting health insurance, and we will continue to make progress in the years ahead so that, hopefully, at some point in the not-too-distant future, everyone in america will have health insurance. so, thank you very much. gwen: my final thing is to say aca is here to stay, and i thank god for that. ron: thank you. neil: hello, my name is neil katyal, a partner and former acting solicitor general of the united states. today's decision is a resounding victory for the president and for congress and for the american people. the supreme court by a 6-3 decision overwhelmingly upheld what the president has been saying all along, which is that

these health insurance exchanges, whether set up by the state or federal government, provide subsidies to individuals who can't otherwise afford them. i was sitting in the courtroom as the decision came down, written by the chief justice who, after all, was appointed by president george w. bush. and for the first ten minutes, you could see right away where the decision was headed. the chief justice started off by saying that the affordable care act was based on three premises, three kind of legs of a stool. one was, there was a lot of discrimination in health insurance. and so, you had to get rid of that discrimination with so-called guaranteed issue requirements, allowing everyone access to the insurance markets. the second piece of it was the chief said, congress said, well you also have to have an individual mandate. you have to have something to insure that people buy that insurance. and then the third piece of it was the subsidy, to make sure people could afford the insurance that the affordable

care act requires them to have. the supreme court, the chief justice said that's precisely what the affordable care act does and how it's written. it was a resounding victory for the government and a resounding victory for the current solicitor general, don virlie, who gave the oral argument of a lifetime in explaining why the president's interpretation was the correct one. today, we have for the second time in three years a republican-dominated supreme court upholding the democratically elected affordable care act. it's a resounding victory for the president and for the congress and for the american people. thank you. >> justice antonin scalia wrote the dissent in the decision. he called it quite absurd. in c-span's supreme court series from 2009, he talked about why

he enjoys writing dissents. antonin scalia: dissents are more fun to write. when you have a dissent, it is yours. you say what you want. if someone doesn't want to join it, who cares? this is what i want to say. when you are writing the majority, you do not have that luxury. you have to crafted in a way that at least four other people can jump on and actually, you try to crafted in a way as many people will jump on. which means accepting suggestions stylewise that you don't think are the best, but nonetheless, to get everybody on board you take them. >> a number of senators weighed in on the decision. which ruled that health care subsidies should be available to states without exchanges. we will hear from senate minority leader harry reid followed by majority leader

mitch mcconnell. senator harry reid: today, the great country of ours, the affordable care act, obamacare has survived and attended cut to working families -- millions of working families. america won today. the supreme court ruled against republicans who were seeking to strip 6.5 million americans of their insurance. it is very pure very simple. , over 10 million americans are covered on the exchanges. operating across the country they are insured for the first time. 85% of these men and women receive tax credits to help them afford that coverage. but on top of that, 12 million more americans now have coverage for the medicaid and children's health insurance programs.

they found that more than eight in 10 adults people who have , these programs, are satisfied with the programs. the affordable care act is not perfect. no law ever is. but this law is working for millions and millions of americans, approaching 20 million americans. once again, the affordable health care act prevailed. so mr. president, i say , respectfully to my senate colleagues, and i mean that, stop banging your head against the wall. this legislation passed. it is the law of the nation. stop it. move on. the program should pause for a minute and look back. mr. president, i don't know the number anymore. i don't know, i lost count of it. is at 75? certainly approaching 100 about to vote have taken place to repeal the law. never even came close to passing of course but have done it time and time again. stop it.

think of the time wasted doing that. as einstein said, the pure definition of insanity is someone who keeps doing the same thing over and over again and gets the same results. i would hope republicans would rethink what they have been up to. reckless cynical attempts to increase tax and millions of americans. that's what it amounted to. i was interested in looking at the paper today at what republicans have suggested to do if the supreme court ruled against this law. every one of them without exception would be a tremendous blow to the budgeting process in america. this bill makes america money.

it's cut the deficit significantly and that's what i say it makes the country money. it allows for more healthy nation. republicans were not content to jeopardize the health of americans. they wanted to exact political advantage against president obama. they were happy trying to do that. so, mr. president, i also think it's important to note that republicans who worked on this legislation in the process going through the committees, they admit the legislation drafters never discussed withholding subsidies in the manner suggested by the plaintiff. republicans said that who worked on the legislation.

so, mr. president, i think the public has basically had it with republicans trying to take away a law that protects them from insurance company discrimination when they get sick or hurt. enough is enough. i had an early thursday. i had a group of people there from nevada who have family members who suffered from cystic fibrosis. they were able to tell me that for the first time in the life of their children they could not be denied insurance. they are adults now. they can't be denied insurance coverage as of this law. if it had been repealed, people with cystic fibrosis and many other diseases would not be able to get health insurance. so, mr. president, let's move on this topic. stop this, stop wasting time the time of the american people by trying to repeal the law. i appreciate the work done in the supreme court, a good decision, a strong decision that

upheld the law. enough is enough. let's move on. mitch mcconnell: mr. president we're even discussing another one of obamacare's self-inflicted brushes with the brink yet again is the latest indictment of a law that's been a rolling disaster for the american people, a rolling disaster for the american people. today's ruling will not change obamacare's multitude of broken promises including the one that resulted in millions, literally millions of americans losing their coverage they had and wanted to keep. today's ruling will not change obamacare's spectacular flops, spectacular flops from humiliating website debacles to the total collapse of exchanges in states run by the laws 's loudest cheerleaders. today's ruling will not change the skyrocketing cost in

premiums, deductibles, and co-pays benefit the middle class so hard over the last few years. the politicians who forced it on the american people now have a choice. they can crow about obamacare's latest wobble towards the edge or work with us to address the ongoing negative impact on 2000 page law that makes miserable lives for so many of the same people it purported to help. >> the senator from south carolina. senator lindsey graham: i would like to be recognized for five minutes to speak in morning business. >> without objection. senator lindsey graham: thank you. i have two very brief comments. one involves our national security, the world at large the other involves our nation as a whole. first as to the supreme court ruling.

i'm surprised, i'm disappointed but the ruling is now in and senator mcconnell said it well. this doesn't mean that obamacare is fixed. it means that it is going to continue until somebody finds a better way or will be left with obamacare for the rest of our lives and your children's lives and those that follow. 2016 race, domestically, will be centered on health care as the most dominant domestic issue in the country. if you're running for the house you are running for senate or running for president, here is what this supreme court ruling means. if the public wants to continue obamacare, which i think would be a huge mistake, vote democrat. if you want to repeal and replace the obamacare with something better for you and your family, bipartisan, vote

republican. hillary clinton, the most likely democratic nominee, will make obamacare her own. whoever the republican party may whoever the republican party may nominate, the one thing i can assure you is that they will repeal and replace obamacare with something better. so that these united states will finally have a chance to have your say. this election in 2016 for the house and senate and the white house will give you a chance to stop obamacare and replace it with something better for you and your children. take advantage of this opportunity. because if we fail to have the people in place in 2016 to

change course, obamacare becomes cemented in terms of the american health care system and our economic future. i think it would be a mistake for the ages. >> i want to talk about jobs and the economy and people's health care. they are all related. we are in the midst of one of the slowest growth periods for the economy in the recent history of the united states. they just revised the figures again. that is three times that the figures have been revised for the last quarter. they now show a 2/10ths of 1% growth. they should be showing about a 2% growth for the year. why is that it will? -- why is that a problem?

results in $300 billion-$400 billion of tax revenue. when it is less and 2% that means we are losing that much in additional money. we have to make decisions on about 1100 billion dollars a year. we are overspending that by 50%. no country can afford to do that, no city can afford to do that, no state can afford to do that. the federal government can because we just borrow more people there is a lot of confidence in this country that we can just continue to borrow more. there are some areas in this country where job growth and the economy growth is impeded. it is health care. president obama is disconnected from the harsh reality that his health care law has created for people. speaking two weeks ago, the

president said "part of what is bizarre about this whole thing is we have not had a whole lot of conversation about the horrors of obamacare because none of them have come to pass." none of them have come to pass? how insulated is our president? i want to emphasize what he said . "none of those horror stories have come to pass." i hear a drastically different story from folks across wyoming and other parts of the country. people like one woman who complained to me that her and her husband's health insurance went up from $11,000 per year to $20,000 per year and then had a deductible thrown in that was $6,500. how is that affordable? people like a retired nurse from casper who told me that if you add the premium increases that she and her husband are up

$36,000 per year. she wrote that health care is unaffordable. it is a huge burden. how can people afford to pay more for health care than they make in a year? she said obamacare does not provide them with coverage for their medical needs and that it goes against everything they believe in for america. people like the man from cheyenne who says that the president's health care law is forcing him to choose between paying for his health care or paying for his mortgage. people like a small business owner in newcastle who says that before the affordable health care law, she could afford to pay for her employees' health care. after the law, she could not be at her employees could not afford it either so they might leave for a bigger company which probably is impossible. it's -- the small business owner might have to sell out to a bigger company which, many

times, is also not going to be possible. she loves her community and wants to stay active as part of it. she is discouraged by the situation this health care law has created. it is asking for help. we have been asking for help for several years now. the president has recognized that there needs to be some help it otherwise, there will be some real calamities. why haven't they happened? well, some of them have. i have described some of them to you. some of them have not paid that is because the president has written a waiver on some of the things he knows are atrocious and will cause a huge problem. did he have the authority to do the waiver? not really. but he did them and that is to put off the tragedies until later. it is not what we ought to be doing. we ought to be making health care more affordable. there are lots of plans around here for making it more affordable. most of those are just discarded. the bill that went through here

went through and there was a 60-vote majority on that side of the aisle to 60 votes is enough to pass anything through here. neither party will have a 60-vote majority again because you do not have to listen to the consequences. another 435 background on the house side. why do we have so many full in congress? so that we have those diverse backgrounds and we can find those unintended consequences. and i just for them. the people that i mentioned are real people, real families. they did not write the story. they and many more like them contacted me. they are telling me and all of us in washington to do something about this unworkable health care bill for millions of americans that is far from affordable, breaks promises, and

makes life harder. i am listening to you. so should the torch carriers of this federally-mandated dream that was broken before it began. today's supreme court ruling on king versus burwell is surprising, but it reminds all of us who warned against this law that we will have our work cut out for us to move our country away from the failed policies. this law was written and implement it in its entirety by one party. it has been informed from the start by ideology rather -- a number of us were working on health care before the president even became a senator and continued to work on it. it had a lot of discarded ideas. could have increased competition, brought prices down. this law was implemented and written in its entirety by one party and it has been formed by ideology.

the federal government cannot possibly know what is best for each individual. as we have seen, a one-size-fits-all dictate does not work. the stories i relayed and millions more like them to -- from every straight are -- from every state are examples of that. that is just a small sample of the hundreds of people who write to me across wyoming. i hope to offer them new choices for quality health care. we want to protect families as we get rid of obamacare and transition away from this fiasco. that is what it is, as illustrated by the testimonials i talked about earlier and hundreds of more -- hundreds more i have. it is time for the republicans and democrats to deliver on the

president's promise of a health care system that expands access and promotes quality, that has patient-centered care while actually bringing the cost down. that is possible. just not under that bill. this is an opportunity for both parties to work together to put into place real solutions that rely on these principles. i think they just announced that one of the federal insurance co-ops is going out of business. all of them are severely in the red. those would be government-sponsored entities who said too much was being charged for health care by many of the insurance companies and they went for far lower premiums. that was the hope that it would bring down the price, but it did not. that is not the way to encourage the kind of competition we need if we are going to bring down health care costs. one of the things that we focused on around here is small

business health plans for small businesses. small businesses are the ones that are having the problem. one man said, you know, i have a successful business and i just got this tremendous location. i could put in another one. but that would put me over 50 employees. that puts me in a different category on health care costs. the people working for me like the health care costs we are providing, but i would have to go to a whole different level or pay huge fines and i cannot afford to do that, so i am not going to open another location and put 50 more people to work. for too long, the debate over health care has placed politics over the best interest of patients. it is time for democrats and republicans to deliver what the president promised but ultimately failed to deliver. we need a health system that expands access and promotes quality patient-centered care

while bringing costs down. we must allow states the freedom and flexibility to ensure hard-working americans can get the care that they need to do it is time for both parties to work together on real solutions. we should move forward on a bipartisan basis to provide more choices and a better health-care system for hard-working americans. i yield the floor t. senator barrasso: i come to the floor to congratulate the senior senator from wyoming, who has been a true leader in health care reform. the proposals that he has made would help people get affordable care. the obama health care law regardless of the ruling in the supreme court, continues to be an expensive failure. there have been so many broken promises by this president about health care in america. to me, it is a reason why this

health care law's support across the country remains at an all-time law. people were told that if they like their coverage, they could keep their coverage. millions of lost coverage. the president has promised if you like your doctor, you can keep your doctor. millions have lost their doctors. the president said premiums would go down by $2500. instead, premiums have gone up and there is no end in sight. when i take a look at this and say why is the support so low it is because most people believe it is a bad deal. they are paying more in premiums, higher co-pays, higher deductibles, all of which makes it a bad deal for them personally. mr. president, i would say that obamacare cannot be fixed, but health care in america must be fixed.

they say what are you going to do about it as a republican? there are incredible republican plans out there, each of which is much better than the president's health care law. we still have 30 million americans without insurance. concerned about the fact that they still need care. we are going to continue to work to repeal and replace this health care law with a law that will allow people to get what senator enzi has been talking about. we need people and patients to get the care they need from a doctor they choose at lower costs. that is what republicans are committed to. and that is what republicans, in spite of today's ruling by the supreme court, will continue to work for. thank you, mr. president. i yield the floor. senator murphy: thank you, mr.

president. hopefully, we can move on. after the presidential election, two supreme court cases, 60-plus votes to repeal the affordable care act in the house of representatives, endless debates here in the united states senate , maybe now is the moment where republicans will choose to close the books on trying to strip away from millions of americans the benefits that they have received from the afford will care act. -- the affordable care act. this is an important day for over 10 million americans who have health care right now because of the affordable care act. i would argue it is an important day as well for the separation of powers, the recognition that it is the legislative body that sets policy for this country.

and i just wanted to come down to the floor for a few minutes to express my hope and my desire that proponents of the affordable care act like myself senator stapp now -- stabenow and senator baldwin, who have come to the floor multiple times over many years, do not have to do it again. i would love to talk about the needs of our transportation system, mental health reform tax reform. i have come to the floor over and over again to defend the affordable care act simply because it has been perpetually under attack, despite the fact that its successes are now unparalleled. justice roberts, in the decision today, i will not quote from it at length -- "congress passed the affordable care act to improve health insurance markets, not to destroy them." that is the operative phrase in

today's decision. and that is what it has done. it has improved marketplaces all across the country. why? because people who voted with their feet 10 million, 11 million people who have signed up for expanded medicare medicaid coverage, or these exchanges, have shown us that the law worked as intended because they did not stay out. they did not deem it to be unaffordable. they stepped in and brought -- and bought coverage. we should now be in the business of perfecting this law. none of us think that this law is perfect. many are open to conversations about how to make it that are how to perfect this. hopefully, now that the supreme court has completely shut the

door to a judicial repeal of the act, and after debate after debate, it is clear that there are not the votes, nor the support. hopefully we can move onto something else. madam president, this is an old chart of mine. i brought this down to the floor several months ago, when a colleague of ours suggested that we should not be, the administration should not be celebrating the successes of the affordable care act. as if people receiving health insurance for the first time in the life was not something to celebrate. 17 million children with pre-existing conditions will never have their health care taken away from them was not something to celebrate. as if 9.4 million senior

citizens who are saving $15 billion on drugs is not something to celebrate. i get excited when i talk about the affordable care act because i know it is a really sober and important topic. when i talk to my constituents back home, they are excited. they are bubbling over with enthusiasm, those of them who never had the chance to get health coverage before the affordable care act. that a child would not be able to live a normal life because they would not be able to cover a complicated illness without insurance. there are millions celebrating this decision today. hopefully we will have a conversation about how we can move on to another topic. but it is a day to celebrate. for the 6.4 million americans

first and foremost, who would have had their insurance taken away by an adverse decision, but for all americans who would have been caught up in an insurance death spiral had the decision gone the other way. i hope that we can limit our discussions about the affordable care act two ways in which we can make it work better. i hope we can spend more time talking about other things that matter to this country. i hope that the house of representatives decides to give up this obsession with repealing the affordable care act something that is simply not going to happen. and for its opponents out in the field, the supreme court has shut the doors to a judicial repeal of the affordable care act today. i think of a lot of stories when i think about what the affordable care act has meant to the people of connecticut. we have cut our insurance rate

in half in connecticut. we have one of the best-running exchanges in the country. but one of the stories, the only one i will convey as i wrap up -- i was at the community pool that my family has gone to in cheshire, connecticut. i was in the pool with my then two-year-old just shortly after the passage. a young man about my age came up to me and he said, listen, i am sorry mr. murphy, to disturb you. i know you are here with your son. i have a little boy, too. he has a congenital heart problem. every single day since he has been born, i was worried that he would not get to live out his dreams because his life decisions would be dictated by whether or not he could get

insurance to cover all of the complicated health care needs he is going to have. that would be determinative of his path in life not his dreams, his desires for himself. and he said, i get it that this is going to help a lot of people in very practical and economic ways. i just want to thank you because now i sleep better at night, knowing that my son is going to be able to get coverage, that my son is going to be able to lead a relatively normal life, and that he can be whatever he wants to be. that is the benefit of the affordable care act. it is not just practical, not just economic, not just whether someone has insurance or not. it is psychological. it is peace of mind. the supreme court has protected 6.4 million people from losing

their health insurance today. but they also protected tens of millions of patients and parents and sons and daughters and grandparents from losing that peace of mind that comes with the protections of an affordable care act that is working. i yield the floor, mr. president. senator cruz: today's decision in king versus burwell -- for the second time in just a few years, a handful of unelected judges has rewritten the text of obamacare. in order to impose that failed law upon millions of americans. first time, the court ignored federal law and magically transformed a statutory penalty into a tax.

today, these robed houdinis have transmogrified a federal exchange into an exchange "established by the state." this is lawless. and justice for leah rightfully put it -- "words no longer have me -- have meaning." if an exchange that is not established by the state is established by the state. justice scalia continued, "we should start calling this law scotus-care." i agree. if this were a bankruptcy case or any other case of ordinary statutory interpretation, the result would have been 9-0 with the court unanimously reversing the obama administration's illegal actions. instead, politics intervened.

for nakedly political reasons, the supreme court willfully ignore the words that congress wrote. instead read into law there preferred policy outcome. these judges have joined with president obama and harming millions of americans. unelected judges that once again become legislators, and bad ones at that. they are lawless. and they hide their prevarication in legalese. our government was designed to be one of laws, not of men. this transparent distortion is disgraceful. these justices are not behaving as umpires calling balls and strikes. they have joined a team and it

is a team that is hurting americans across this country. obamacare is the biggest job killer in america. millions of americans have lost their jobs and have been forced into part-time work, have lost their health insurance, have lost their doctors. millions of americans have seen their health insurance unions skyrocket. it is a direct result of president obama, of democrats in the united states congress, and of lawless judges in the united states supreme court, who have joined the team of the obama administration. if those justices want to become legislators, i invite them to resign and run for office. that is the appropriate place to write laws on this floor. not from that courtroom. mr. president, i began my career as a law clerk at the united states supreme court.

clerking for chief justice william rehnquist, one of the greatest chief justices ever to serve our nation. i spent the majority of my adult life litigating before the united states supreme court. both on behalf of the state of texas and private parties. what this court has become is heartbreaking. if chief justice rehnquist could see this court today, he would be filled with sorrow at what has become of the supreme court of the united states. the obligation of fidelity to constitution and fidelity to law matters. we hear not living in a platonic oligarchy with philosopher kings governing us who believe they

get to write the laws, interpret the laws, enforce the laws. that is not the american system of governance. at the same time, mr. president, crocodile tears are flowing here in our nations capital. over the supreme court decision to illegally rewrite obamacare which has been a disaster since its inception. but one day of fauzx outrage from the washington cartel will not fool the millions of courageous conservatives all across our country. they know that far too many career politicians, democrats and republicans, in this nation's capital, are quietly celebrating the court's decision . they believe it -- if they believe this issue is now settled so they do not have to address it, they are sorely mistaken.

i have made repeal of this disastrous law a top priority since the very first day i entered this body. i have made its repeal central to my tenure in office. republicans all across the country, including my friend mr. president, the presiding chair, campaigned on repealing this law and were elected in an historic tidal wave year historic majorities in both chambers of this body. and in statehouses all across the country. it is now up to us to keep our promises. i believe 2016 will be a national referendum on repealing obamacare. this law is profoundly unpopular. it is unpopular with republicans. it is unpopular with independents. it is unpopular with democrats.

it is unpopular with young people. it is unpopular with hispanics. it is unpopular with everybody it is hurting. and there are millions being hurt by this law. the court adopted and put its stamp of approval on the irs' blatantly unlawful reading of the statute, to make subsidies and taxes applicable to individuals on federal exchanges when congress explicitly provided the opposite. jonathan gruber famously said "obamacare was built on exploiting the stupidity of the american people." unfortunately, the supreme court is now complacent -- complicit in that deception. the supreme court has joined president obama, whose statement "if you like your health insurance plan, you can keep your health insurance plan," was

rightfully noted as the lie of the year as millions of americans lost their doctors. now this row of justices are complicit in that lie. setting aside their oath of office to lie to the american people. after today's ruling, obamacare will now be responsible for imposing illegal taxes on more than 11 million individuals. and for burdening hundreds of thousands of businesses with illegal penalties on their workers, killing jobs and further slowing economic growth. you are a young person right now. you come out of school. you have student loans up to your eyeballs. you are struggling. you do not know if you are going to get a job. the dismal economy means your future is bleak. you have no hope for optimism about beginning a career, gaining