Well, it can refer to a nation. But the intent was so clear that only a pedantic fucking asshole, completely ignoring the obvious intent of the legislature and purpose of the legislation, would have ever bothered to read it any other way.
I will grant you that the word, when written, referred to the states, but it is a pleasant coincidence that the word has a broader definition which can be interpreted if
clever and compassionate people choose to do so that the
obvious intent of the broader legislation can be served and not be undone.
Undone by a combination of three missing words in the legislation and a series of conservative leaning state governments who prefer to deny their more unfortunate citizens access to more affordable health insurance options (even though it doesn't cost those states hardly any money).
I guess that the drafters of the bill should have considered the fact that Republican state leaders would sooner spit on their poorer constituents than offer them help up off the floor. They stay they are standing on principle but it's actually despicable.
And Republicans wonder how Democrats have won the popular vote in 5 of the last 6 presidential elections.