Supreme Court to Hear Obamacare Suit

[Jimmy Higgins]

You keep repeating this, but the claim seems hollow.

• The ACA states that an "Exchange" is defined solely in 1311.
• 1321 authorizes an "Exchange" to be created by the Secretary of Health where a State refuses to put an Exchange together
• 1321 (nor anywhere else) does not specifically define or establish regulations for an Exchange established by the Secretary of Health, outside of those established for Exchanges "established by the State"

Because there is no other definition or regulation of an Exchange (for those established by the Fed within a state), it has to be referencing 1311. If it is referencing 1311, that means "established by the State" is broader than opponents of the ACA claim it is. Otherwise the provision in 1321 would be nonsensical. Why would it authorize an Exchange that can't be created?

Once again, you just lost the argument for the government by relying exclusively upon 1311 language (exchange established the State") which is different and says something entirely different than the language of (exchange established by the Secretary of Health) in 1321.
The State is not the same as the Secretary of Health. The Secretary of Health is not the same as the State. In other words, X=State and Y=Secretary of Health. 1311 references an exchange as one in which X establishes the exchange. 1321 references Y as establishing the exchange. X and Y are not the same, hence those two phrases are asserting two different things, and asserting two different entities to do something.

Now, what you have done above is to actually argue beyond the meaning of 1311, which is very wise of you.

You can keep saying I've lost and want to pretend that 1311 is some sort of Excaliber for the right-wing. But I think I have shown that 1311 actually cuts the other way.

Because 1311 is the official definition of an Exchange, we have the basis of what an Exchange is. But 1311 being the definition doesn't end the game, simply because of the text "established by the State", as the rest of the Bill can apply context as to what "established by the State" includes.

If it is referencing 1311, that means "established by the State" is broader than opponents of the ACA claim it is. Otherwise the provision in 1321 would be nonsensical. Why would it authorize an Exchange that can't be created?

First, what are you referencing by the word "[it]"? Second, 1321 authorizes the Secretary of Health to establish an exchange when the State does not establish an exchange. I am not quite sure how exactly you are deducing "[it] would authorize an Exchange that can't be created."

"It" is 1321.

The official definition of an Exchange is established in 1311. Therefore when 1321 establishes authority to create an Exchange, it can only be authorizing an Exchange as defined in 1311. 1311 includes the text "established by the State". If that text is held to the extent of literalness, that means a Federally established Exchange can not actually be established because the Fed is not a State.

For clarity, I'll just repost this:

1. The definition to Exchange is established in 1311.
2. 1321 clearly authorizes Federally overseen Exchanges within a State if a condition is met.
3. Because only 1311 exists as a definition to Exchange, 1321 has to be authorizing a Section 1311 Exchange.
4. If a Federally overseen Exchange within a State is a 1311 Exchange then that means "established by the State" has to include Federally overseen Exchanges to coincide with 1311(d)(1).

 

[dismal]

[*]The definition to Exchange is established in 1311.

Do you have any arguments for ignoring clear and unambiguous language in the law that don't start with this rather baseless assertion?

 

[Jimmy Higgins]

[*]The definition to Exchange is established in 1311.

Do you have any arguments for ignoring clear and unambiguous language in the law that don't start with this rather baseless assertion?

That reply seems aloof seeing I already cited Section 1562 which indicates that the definition for an Exchange is established by the text in Section 1311. Here is a link to the bill. Look up Section 1562.

 

[dismal]

Do you have any arguments for ignoring clear and unambiguous language in the law that don't start with this rather baseless assertion?

That reply seems aloof seeing I already cited Section 1562 which indicates that the definition for an Exchange is established by the text in Section 1311. Here is a link to the bill. Look up Section 1562.

I read legal documents all the time. There are two main ways definitions are established. First and most directly, there is a list of defintions titled "Defintions".

Secondly, on the first occurrence there is a passage in general English, followed by a capitalized example of the term to be defined inside parentheses with quotes.

For example: customer shall be in a place where people go to east breakfast on a porch (an "Exchange")

Further uses of the word Exchange with a capital "E" would reference would be tied to this defintion.

If we look at Section 1300 it features both practices. There is a list of definitions, reproduced here in part:

SEC. 1304. RELATED DEFINITIONS.
(a) DEFINITIONS RELATING TO MARKETS.—In this title:
(1) GROUP MARKET.—The term ‘‘group market’’ means the
health insurance market under which individuals obtain health
insurance coverage (directly or through any arrangement) on
behalf of themselves (and their dependents) through a group
health plan maintained by an employer.
(2) INDIVIDUAL MARKET.—The term ‘‘individual market’’
means the market for health insurance coverage offered to
individuals other than in connection with a group health plan.
(3) LARGE AND SMALL GROUP MARKETS.—The terms ‘‘large
group market’’ and ‘‘small group market’’ mean the health
insurance market under which individuals obtain health insurance
coverage (directly or through any arrangement) on behalf
of themselves (and their dependents) through a group health
plan maintained by a large employer (as defined in subsection

There is also an example of the quotes and parentheses approach to be found in Section 1311 (A)(5)(b)(1):

(1) IN GENERAL.—Each State shall, not later than January
1, 2014, establish an American Health Benefit Exchange
(referred to in this title as an ‘‘Exchange’’)

Anyone with the slightest knowledge of legal documents would think that this is the point where "Exchange" is defined for this title. It means "an American Health Benefit Exchange".

To argue:

(d) REQUIREMENTS.—
(1) IN GENERAL.—An Exchange shall be a governmental agency or nonprofit entity that is established by a State.

Is a definition is complete silliness. a) The word "Exchange" was already defined; b) the passage does not follow the convention for defining terms, but of using a previously defined term; c) it's in a section called motherfucking REQUIREMENTS!

This passage is a requirement that an Exchange (as previously defined) be a non-profit entity or state agency.

 

[PyramidHead]

(d) REQUIREMENTS.—
(1) IN GENERAL.—An Exchange shall be a governmental agency or nonprofit entity that is established by a State.

There are two ways to read this line:

1. An Exchange shall be a...

(a) governmental agency

or

(b) nonprofit entity that is established by a State.

2. An Exchange shall be a...

(a) governmental agency

or

(b) nonprofit entity...

...that is established by a State.

See how "that is established by a state" can be interpreted to apply to both parts, or just the second part? If number 1 is true, then a federal Exchange meets the requirements: it is a governmental agency.

 

[Jimmy Higgins]

(1) IN GENERAL.—Each State shall, not later than January
1, 2014, establish an American Health Benefit Exchange
(referred to in this title as an ‘‘Exchange’’)

Anyone with the slightest knowledge of legal documents would think that this is the point where "Exchange" is defined for this title. It means "an American Health Benefit Exchange".

To argue:

(d) REQUIREMENTS.—
(1) IN GENERAL.—An Exchange shall be a governmental agency or nonprofit entity that is established by a State.

Is a definition is complete silliness.

Agreed. That would be complete silliness. What was your point again?

Because what I said was that Section 1562 modifies the Public Health Services Act (a bill originally passed in 1944) to include the definition of Exchange.

(b) Definitions- Section 2791(d) of the Public Health Service Act (42 U.S.C. 300gg-91(d)) is amended by adding at the end the following:

• ‘(20) QUALIFIED HEALTH PLAN- The term ‘qualified health plan’ has the meaning given such term in section 1301(a) of the Patient Protection and Affordable Care Act.
  
  
  ‘(21) EXCHANGE- The term ‘Exchange’ means an American Health Benefit Exchange established under section 1311 of the Patient Protection and Affordable Care Act.’.

It establishes that Section 1311 is key. There is little disagreement here. But is the significance of the text source for anti-Obama-ites to start orgasming?

There is only one type of Exchange... one established by the State. Section 1321 indicates that the Secretary of Health is authorized to create an Exchange within a State. There is no text in Section 1311 about a different Exchange that is established "by the Secretary of Health". Therefore, in order for Section 1321 not to be nonsensical, that means an Exchange created by the Secretary of Health within a State is considered by the Law to be 'by the State'. Otherwise, there would be no legal standing for such a federally created Exchange to be established.

 

[maxparrish]

This is rather simple. There is a difference not only in language but also in meaning, between the phrases of "exchange established the State" and "exchange established by the Secretary of Health."

Section 1311 references exchanges as a nonprofit/governmental agency established by a State.

Hence, unless the government wants to increase its risk of losing then they aren't going to rely on Section 1311 as the definition and look nowhere else or not rely upon other provisions for its meaning.

You keep repeating this, but the claim seems hollow.

[*]The ACA states that an "Exchange" is defined solely in 1311.

Presumably you are claiming this on the basis of 1311 (d). If so, you are mistaken. This is not a definition (sole or otherwise), but a requirement. Section 1311(d), is titled as “REQUIREMENTS,” and says “(1) IN GENERAL. — An Exchange shall be a governmental agency or nonprofit entity that is established by a State.” 42 U.S.C. § 18031(d)(1).

Congress required of 1311 exchanges that be either a governmental agency OR a nonprofit entity that is established by the State. They can be one or the other.

Read Section 1311(b)(1)(C) and 1311 (d)(1):

(b) AMERICAN HEALTH BENEFIT EXCHANGES.—
(1) IN GENERAL.—Each State shall, not later than January
1, 2014, establish an American Health Benefit Exchange (referred
to in this title as an ‘‘Exchange’’) for the State that—
(A) facilitates the purchase of qualified health plans;
(B) provides for the establishment of a Small Business
Health Options Program (in this title referred to as a
‘‘SHOP Exchange’’) that is designed to assist qualified employers
in the State who are small employers in facilitating
the enrollment of their employees in qualified
health plans offered in the small group market in the
State; and
(C) meets the requirements of subsection (d).

So each state shall establish an AHBE that meets the requirement that the Exchange shall be either a government agency or a non-profit established by the State.

Such reading gives meaning to every phrase, removes surplus language, removes conflict, and causes no violence to the text. Your reading violates these textual principles.

[*]1321 (nor anywhere else) does not specifically define or establish regulations for an Exchange established by the Secretary of Health, outside of those established for Exchanges "established by the State"

That is not true. 1321 directs federal exchanges to meet the requirements listed in 1321 (Subsections A, B, C, etc.). These are the same requirements on states. What it does not do is overturn the plain and explicit language of 1401.

Otherwise the provision in 1321 would be nonsensical. Why would it authorize an Exchange that can't be created?

Correct, therefore 1311 must be read in context, and one must note that it does not DEFINE what an Exchange is, it provides Requirements for a 1311 Exchange.

 

[dismal]

(d) REQUIREMENTS.—
(1) IN GENERAL.—An Exchange shall be a governmental agency or nonprofit entity that is established by a State.

There are two ways to read this line:

1. An Exchange shall be a...

(a) governmental agency

or

(b) nonprofit entity that is established by a State.

2. An Exchange shall be a...

(a) governmental agency

or

(b) nonprofit entity...

...that is established by a State.

See how "that is established by a state" can be interpreted to apply to both parts, or just the second part? If number 1 is true, then a federal Exchange meets the requirements: it is a governmental agency.

It's not a definition. It's a requirement. This is not clear from the context, but from the fact the term was defined already and it's labeled "requirements".

 

[dismal]

Because what I said was that Section 1562 modifies the Public Health Services Act (a bill originally passed in 1944) to include the definition of Exchange.

(b) Definitions- Section 2791(d) of the Public Health Service Act (42 U.S.C. 300gg-91(d)) is amended by adding at the end the following:

• ‘(20) QUALIFIED HEALTH PLAN- The term ‘qualified health plan’ has the meaning given such term in section 1301(a) of the Patient Protection and Affordable Care Act.
  
  
  ‘(21) EXCHANGE- The term ‘Exchange’ means an American Health Benefit Exchange established under section 1311 of the Patient Protection and Affordable Care Act.’.

It establishes that Section 1311 is key.

I suppose you could argue it establishes how Exchange is defined in the Public Health Service Act .

Since we are not discussing the Public Health Service Act currently, but Title I of the PPACA we probably should use this definition:

From Section 1311 (A)(5)(b)(1):

(1) IN GENERAL.—Each State shall, not later than January
1, 2014, establish an American Health Benefit Exchange
(referred to in this title as an ‘‘Exchange’’)

In general the definition of "Exchange" just saves you from having to type out the words "American Health Benefit Exchange" with all the legal heft and significance that carries.

 

[maxparrish]

(d) REQUIREMENTS.—
(1) IN GENERAL.—An Exchange shall be a governmental agency or nonprofit entity that is established by a State.

There are two ways to read this line:

1. An Exchange shall be a...

(a) governmental agency

or

(b) nonprofit entity that is established by a State.

2. An Exchange shall be a...

(a) governmental agency

or

(b) nonprofit entity...

...that is established by a State.

See how "that is established by a state" can be interpreted to apply to both parts, or just the second part? If number 1 is true, then a federal Exchange meets the requirements: it is a governmental agency.

It could be read in various ways, but only one way makes sense. As it is listed as a requirement for the State, and a State cannot establish a non-State government agency, it HAS to mean item 2.

This is what is says is a requirement of the State: "In General - An Exchange shall be a governmental agency or nonprofit entity that is established by a State."

This is what it does not say "Specifically - An Exchange is a government agency, or a non-profit entity that is established by the State.

Had it done so, Higgins (et. al.) might have a valid point.

 

[RVonse]

Which clashes with the reality that there are many instances when Judges will rule based on their OWN discretion. They do so as they will thoughtfully reflect on what type of catastrophic consequences would affect the concerned parties if they stick to the "rule of the law".
Or were you misusing the term "judge" when the correct term would have been Justices when addressing the role of the Supreme Court of Justice in direct relation with the Cato suit?

In our system congress must pass the laws. The courts are not empowered to grant spending authority that congress has not.

This is so basic and fundamental to our system of government that I am surprised we are discussing it.

Then how and why did the courts grant corporate spending authority to buy political ad time for candidates? There was no law passed to make it happen and yet now it does. As a matter of fact, there were campaign finance laws that had been passed by congress which are now obsolete because of what the supreme court did.

Clearly, the supreme court does things it has no business doing all the time and this is one of those times. They are glorified political hacks just like the rest of us.

 

[RVonse]

This is an adult discussion about a law. It really has nothing to do with any of us here.

It really has nothing to do with anything you just said.

On the contrary, it is profoundly relevant to the catastrophic consequences of impairing the delivery of affordable insurance plans in 36 states.

It just occurred to me that if Dismal and Max are correct about what the supreme court must do here, then that then opens up another can of worms for violating the equal protection claus of the 14th amendment of the constitution. Sabine Grant will be unfairly discriminated against solely on the basis of living in Florida and not some other state in the United States. You can not preserve a union and have individual states treat people differently.

 

[maxparrish]

On the contrary, it is profoundly relevant to the catastrophic consequences of impairing the delivery of affordable insurance plans in 36 states.

It just occurred to me that if Dismal and Max are correct about what the supreme court must do here, then that then opens up another can of worms for violating the equal protection claus of the 14th amendment of the constitution. Sabine Grant will be unfairly discriminated against solely on the basis of living in Florida and not some other state in the United States. You can not preserve a union and have individual states treat people differently.

That is unlikely because the Equal Protection clause applies to Race, National Origin, Sex, and (increasingly) Sexual Orientation. Federal policy can (and has) had lots of disparate impact on individuals in States. For example, there is nothing illegal in PPACA's "special" provisions to send extra funds to Nebraska in return for Ben Nelson's vote.

 

[James Madison]

Once again, you just lost the argument for the government by relying exclusively upon 1311 language (exchange established the State") which is different and says something entirely different than the language of (exchange established by the Secretary of Health) in 1321.
The State is not the same as the Secretary of Health. The Secretary of Health is not the same as the State. In other words, X=State and Y=Secretary of Health. 1311 references an exchange as one in which X establishes the exchange. 1321 references Y as establishing the exchange. X and Y are not the same, hence those two phrases are asserting two different things, and asserting two different entities to do something.

Now, what you have done above is to actually argue beyond the meaning of 1311, which is very wise of you.

If it is referencing 1311, that means "established by the State" is broader than opponents of the ACA claim it is. Otherwise the provision in 1321 would be nonsensical. Why would it authorize an Exchange that can't be created?

First, what are you referencing by the word "[it]"? Second, 1321 authorizes the Secretary of Health to establish an exchange when the State does not establish an exchange. I am not quite sure how exactly you are deducing "[it] would authorize an Exchange that can't be created."

"It" is 1321.

For clarity, I'll just repost this:

1. The definition to Exchange is established in 1311.
2. 1321 clearly authorizes Federally overseen Exchanges within a State if a condition is met.
3. Because only 1311 exists as a definition to Exchange, 1321 has to be authorizing a Section 1311 Exchange.
4. If a Federally overseen Exchange within a State is a 1311 Exchange then that means "established by the State" has to include Federally overseen Exchanges to coincide with 1311(d)(1).

You can keep saying I've lost and want to pretend that 1311 is some sort of Excaliber for the right-wing. But I think I have shown that 1311 actually cuts the other way.

No, Higgins, 1311 and 1321 do not refer to the same exchanges. The very language used in 1311 is different from the very language in 1321 and this difference is WHY the government, unless it wants to increase its risk of losing, will not adopt your argument as it would pigeon hole them in 1311 but they do not want to be limited to 1311.

Because 1311 is the official definition of an Exchange, we have the basis of what an Exchange is. But 1311 being the definition doesn't end the game, simply because of the text "established by the State", as the rest of the Bill can apply context as to what "established by the State" includes.

My freaking goodness. Then you aren't relying upon the meaning in 1311 if you are relying upon OTHER parts of the statute to determine what else gets thrown into the meaning of 1311 IN ADDITION to what 1311's text already includes by its own language.

Furthermore, there isn't any necessity in looking for contextual evidence elsewhere in the statute to understand the meaning of the phrase exchange "established by the State" because its plain terms tell us what it means, in other words the statutory meaning of the word "State" tells us what the phrase means by defining the word "State."

From the affordable care act.

"Subtitle G—Miscellaneous Provisions
SEC. 1551 42 U.S.C. 18111. DEFINITIONS.
Unless specifically provided for otherwise, the definitions con-
tained in section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91) shall apply with respect to this title.​

Okay, simple enough, well 2791 of the Public Health Service Act defines "State" as,

"

(14) State
The term “State” means each of the several States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.​

WHOOPS! No mention of Secretary of Health constituting as "State." So what does this mean? Well, it means you have pigeon holed the government into a losing argument. Bravo! It also means the phrase an exchange "established by the State" cannot possibly include an exchange "established by the Secretary of Health" as the Secretary of Health isn't included within the meaning of the word "State" as defined by the statute. Whoopsy!

The official definition of an Exchange is established in 1311. Therefore when 1321 establishes authority to create an Exchange, it can only be authorizing an Exchange as defined in 1311. 1311 includes the text "established by the State". If that text is held to the extent of literalness, that means a Federally established Exchange can not actually be established because the Fed is not a State.

All right but then you aren't relying upon the meaning in 1311 when you are throwing OTHER parts of the statute into the meaning of 1311. Second, for reasons stated above, this is a losing argument because the word "State" is not defined as including the Secretary of Health. This is why I used X=State and Y=Secretary of Health because they are two separate and different entities.

 

[Togo]

My freaking goodness. Then you aren't relying upon the meaning in 1311 if you are relying upon OTHER parts of the statute to determine what else gets thrown into the meaning of 1311 IN ADDITION to what 1311's text already includes by its own language.

Which is how legal writing works. One section lays out the base law, with the definitions, and then the other sections vary that for particular circumstances. So 1311 lays out the definition of an exchange, and then 1321 adds additional rules and conditions that can act as variances to that. One of the variations introduced by 1321 is the federal government intervening if the State fails to set up an exchange, but that's still legally a 1311 exchange.

WHOOPS! No mention of Secretary of Health constituting as "State." So what does this mean?

It means that, unless there is a specific variation, these exchanges can only be set up by States. 1322 is a specific variation on who can set up such an exchange.

This is a very common construction in EU and UK law. I have examples of this construction coming across my desk every week. Is US law really that different?

 

[Jimmy Higgins]

If it is referencing 1311, that means "established by the State" is broader than opponents of the ACA claim it is. Otherwise the provision in 1321 would be nonsensical. Why would it authorize an Exchange that can't be created?

First, what are you referencing by the word "[it]"? Second, 1321 authorizes the Secretary of Health to establish an exchange when the State does not establish an exchange. I am not quite sure how exactly you are deducing "[it] would authorize an Exchange that can't be created."

"It" is 1321.

For clarity, I'll just repost this:

1. The definition to Exchange is established in 1311.
2. 1321 clearly authorizes Federally overseen Exchanges within a State if a condition is met.
3. Because only 1311 exists as a definition to Exchange, 1321 has to be authorizing a Section 1311 Exchange.
4. If a Federally overseen Exchange within a State is a 1311 Exchange then that means "established by the State" has to include Federally overseen Exchanges to coincide with 1311(d)(1).

You can keep saying I've lost and want to pretend that 1311 is some sort of Excaliber for the right-wing. But I think I have shown that 1311 actually cuts the other way.

No, Higgins, 1311 and 1321 do not refer to the same exchanges.

What is the regulatory governance for a Secretary of Health Exchange?

 

[James Madison]

If it is referencing 1311, that means "established by the State" is broader than opponents of the ACA claim it is. Otherwise the provision in 1321 would be nonsensical. Why would it authorize an Exchange that can't be created?

First, what are you referencing by the word "[it]"? Second, 1321 authorizes the Secretary of Health to establish an exchange when the State does not establish an exchange. I am not quite sure how exactly you are deducing "[it] would authorize an Exchange that can't be created."

"It" is 1321.

For clarity, I'll just repost this:

1. The definition to Exchange is established in 1311.
2. 1321 clearly authorizes Federally overseen Exchanges within a State if a condition is met.
3. Because only 1311 exists as a definition to Exchange, 1321 has to be authorizing a Section 1311 Exchange.
4. If a Federally overseen Exchange within a State is a 1311 Exchange then that means "established by the State" has to include Federally overseen Exchanges to coincide with 1311(d)(1).

You can keep saying I've lost and want to pretend that 1311 is some sort of Excaliber for the right-wing. But I think I have shown that 1311 actually cuts the other way.

No, Higgins, 1311 and 1321 do not refer to the same exchanges.

What is the regulatory governance for a Secretary of Health Exchange?

How does the ACA define the word "State"? You lost the argument a long time ago because State is specifically defined.

From the affordable care act.

"Subtitle G—Miscellaneous Provisions
SEC. 1551 42 U.S.C. 18111. DEFINITIONS.
Unless specifically provided for otherwise, the definitions con-
tained in section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91) shall apply with respect to this title.


Okay, simple enough, well 2791 of the Public Health Service Act defines "State" as,

"(14) StateThe term “State” means each of the several States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

WHOOPS! No mention of Secretary of Health constituting as "State." So what does this mean? Well, it means you have pigeon holed the government into a losing argument. Bravo! It also means the phrase an exchange "established by the State" cannot possibly include an exchange "established by the Secretary of Health" as the Secretary of Health isn't included within the meaning of the word "State" as defined by the statute. Whoopsy!
​

 

[Jimmy Higgins]

Could you please act like an adult and answer my honest question? What is the regulatory code for an Exchange created by the Secretary of Health. IE, where is it established what rules must be followed? 1311 goes through a lot of text to explain the Exchange created by the State. It includes requirements for the State, Secretary of Health, etc...

Where is the 1311 equivalent for the Exchange created by the Secretary of Health? 1321 authorizes it, but where are the regs/rules?

 

[James Madison]

Which is how legal writing works. One section lays out the base law, with the definitions, and then the other sections vary that for particular circumstances. So 1311 lays out the definition of an exchange, and then 1321 adds additional rules and conditions that can act as variances to that. One of the variations introduced by 1321 is the federal government intervening if the State fails to set up an exchange, but that's still legally a 1311 exchange.

WHOOPS! No mention of Secretary of Health constituting as "State." So what does this mean?

It means that, unless there is a specific variation, these exchanges can only be set up by States. 1322 is a specific variation on who can set up such an exchange.

This is a very common construction in EU and UK law. I have examples of this construction coming across my desk every week. Is US law really that different?

Which is how legal writing works.

Actually, legal writing varies and in particular, statutes vary in how they are written.

One section lays out the base law, with the definitions, and then the other sections vary that for particular circumstances.

This isn't universal, neither is it uniform, and more importantly the ACA did not and does not follow this approach.

So 1311 lays out the definition of an exchange, and then 1321 adds additional rules and conditions that can act as variances to that. One of the variations introduced by 1321 is the federal government intervening if the State fails to set up an exchange, but that's still legally a 1311 exchange.

Yeah, if we ignore the fact the ACA defines the word "State" as something which doesn't include Secretary of Health, then you'd have a more excellent point. But the ACA definition of "State" doesn't include the Secretary of Health, and as a result an exchange "established by the State" is not synonymous with an exchange "establised by the Secretary of Health."

 

[James Madison]

Could you please act like an adult and answer my honest question? What is the regulatory code for an Exchange created by the Secretary of Health. IE, where is it established what rules must be followed? 1311 goes through a lot of text to explain the Exchange created by the State. It includes requirements for the State, Secretary of Health, etc...

Where is the 1311 equivalent for the Exchange created by the Secretary of Health? 1321 authorizes it, but where are the regs/rules?

Could you please act like an adult

Does acting like an adult mean interjecting with an irrelevant and bitter diatribe about engineers as you did about lawyers in a prior post? No, I didn't think so. We both know who is and isn't acting like an adult.

Adults look at the meaning of words, in this instance the ACA defines the word "State" in such a manner as to not include Secretary of Health. What does this mean? Well this means the word "State" does not mean "Secretary of Health" in the ACA. What does this mean? This necessarily means an exchange "established by the State" cannot possibly mean or include an exchange "established by the Secretary of Health." How do we know this to be true? Because the meaning of the word "State" doesn't include "Secretary of Health." Simple analysis, you know, the kind of analysis we expect from people behaving like adults.