[JURIST] A judge for the US District Court for the District of Columbia [official website] on Wednesday rejected [opinion, PDF] a challenge to health insurance subsidies available to people in states that declined to establish their own online marketplaces under the Patient Protection and Affordable Care Act (PPACA) [text; JURIST backgrounder]. The suit argued [complaint, PDF] that the PPACA allowed subsidies in the form of tax credits for people who obtain insurance only in exchanges established by states but not for people in healthcare exchanges created by the federal government. The subsidies are available to people and families who have an annual income level below 400 percent of the current federal poverty level. Judge Paul Friedman noted that “[t]here is evidence throughout the statute of Congress’s desire to ensure broad access to affordable health coverage,” which meant that Congress clearly intended for the subsidies to be available nationwide regardless of whether the exchange was set up by the state or federal government. A lawyer for the parties who brought the suit has already filed a notice of appeal [Reuters report] for the ruling.

This challenge is one of the latest developments and one of several criticisms [JURIST op-eds] concerning the PPACA. Last Monday, Chief Justice John Roberts of the US Supreme Court refused [JURIST report] to grant a temporary injunction blocking the Obama administration from enforcing the PPACA, denying physician groups’ plea arguing the entire law is unconstitutional due to the method of its passing. Earlier this month, US Senator Ron Johnson (R-WI) [official website] filed a lawsuit against the US Office of Personnel Management (OPM) [official website] in the US District Court for the Eastern District of Wisconsin [official website] attempting to block the federal government from paying a portion of the PPACA health care coverage for members of Congress and their staffs. Also this month, the US government filed a motion [JURIST report] asking the US Supreme Court [official website] to remove the stay [JURIST report] on the contraception mandate in the PPACA that was put in place by Justice Sonia Sotomayor. Last December the Supreme Court refused to hear [JURIST report] a challenge [SCOTUSblog backgrounder] by Liberty University [official website] to the PPACA mandate requiring employers to provide affordable health insurance for their employees. In June the US Department of Treasury (DOT) [official website] announced that it will delay enforcing [JURIST report] the PPACA employer mandate for businesses with 50 or more full-time employees until 2015.