One thing I'm curious about, what is the basis for regulating a Federally overseen Exchange if not 1311?
If the subsidy mechanism of 1311 doesn't apply, that'd imply that none of 1311 applies to a Federally overseen State exchange. 1321 (c)(1)(A)(ii)(II) indicates that:
...the Secretary shall (directly or through agreement with a notforprofit entity) establish and operate such Exchange within the State and the Secretary shall take such actions as are necessary to implement such other requirements.
"such Exchange", as in the same type of Exchange the State was required to create. The Fed is given no change or exceptions in the existing regulation, but that they are instructed and authorized to "establish and operate such Exchange within the State..." No distinction is made here.
The plain text overwhelming conveys the intent of the law (let alone the legislative and political history). Irrespective of a single phrase of alleged ambiguity, if you take the time to read the most important sections and put it on the scales of Lady Justice (assuming she is still blindfolded) it easily bottoms out on one side of intent. Recognizing this as a legal reality does not force you to believe ACA is/was a bad idea, or that there is not a potential loophole or a minor ambiguity, but it does provide respect for scholarship and law.
After reading all the pivotal sections, I find little or no ambiguity. In sum:
Section 1311 provides a directive, that ‘‘Each State shall, not later than January 1, 2014, establish an American Health Benefit Exchange (referred to in this title as an ‘Exchange’)’’. It then provides the 1311 rules/requirements for States. It requires that an Exchange must be ‘‘a governmental agency or nonprofit entity that is established by a State.’’ Section 1304(d) clarifies, ‘‘In this title, the term ‘State’ means each of the 50 States and the District of Columbia.’’
Section 1321 directs the Secretary to create an Exchange in states that fail to create an Exchange or fails to implement the federal insurance regulations. Specifically 1321 says ‘‘the Secretary shall (directly or through agreement with a not-for-profit entity) establish and operate
such Exchange within the State and the Secretary shall take such actions as are necessary to implement such other requirements.’’
So there are two types of exchanges, one is an exchange complaint with particular requirements for the State, and the fallback federal exchange created under 1321.
The presumed support for the "loophole" is in miscellaneous provisions, in Section 1563(b), amending Section 2791 (d) of the Public Health Services Act reads: ‘‘The term ‘Exchange’ means an American Health Benefit Exchange established under section 1311 of the Patient Protection and Affordable Care Act.’’
The "shoehorn" logic is: if "Exchange" means an "AHBE under 1311", then the direction to the Secretary to create "such Exchange" means that 1321 and 1311 are equivalent. Inventive to be sure, but the problem is that the provision does not literally say that, and the remainder of the Title is clearly incompatible with such a view.
Whatever AHBE requirements "under" 1311 are, and however a Section 1321 exchange may have to meet the same Title I requirements, a state Exchange formed under Section 1311 is not literally a 1321 federal Exchange. They may be (in your view) annoying legal distinctions without a functional difference, but they are still legally distinct. Section 1321 exchanges are authorized under different provisions, and have been treated differently in amendments by Congress.
And Section 1401 expressly and repeatedly restricts tax credits to those Exchanges "established by the State under Section 1311". It does not provide those benefits to 1321 Exchange. However a 1321 federal exchange is like a AHBE Exchange under the rules of 1311 , it is NOT a 1311 AHBE Exchange ‘‘established by a State.’’
In short, Section 1321 directs the Secretary to create such Exchanges that are identical in form to an AHBE under Section 1311 requirements, but 1401 provides benefits ONLY for those who State citizens use 1311 Exchanges.
There is only ambiguity for those who are looking for a needle in a haystack, and then if found, claims that that they actually found a needle-stack.
FYI: More Background Notes on Two Provisions:
Section 1401 (and indirectly 1402) gives specific authorizations of tax credits and cost-sharing subsidies but only for 1311 exchanges. This is not a case of errant phrasing, it is very clear as seven times it says so, repeatedly pointing out that it only occurs when the taxpayer is in an Exchange "established by the State under section 1311".
Section 1421 gives authorization for tax credits for small businesses under
an exchange. The word "exchange" (no caps) refers to state Exchanges and federal Exchanges. The contrast between the two sections (1401 and 1421) in this case highlights the authorizations intended.
Therefore PPACA makes small business tax credits available to state and federal Exchanges, but makes premium tax credits only available in state Exchanges.