Four words, six syllables — that’s all it took for the Affordable Care Act to punch a return ticket to the U.S. Supreme Court.

Sure, there are the teams of lawyers, reams of legal documents, millions of dollars and endless
debates that go along with each case put before the court’s nine justices. But the latest chapter in the Obamacare saga — the case known as King v. Burwell — will revolve around the simple phrase “established by the State,” and whether it should be taken literally.

Burt Rublin, leader of the appellate group practice at Ballard Spahr in Philadelphia, cites the example in a February decision of a commercial fisherman who threw some undersized red grouper overboard from his boat in order to avoid incurring the wrath of Fish and Wildlife officials. The fisherman was prosecuted under the Sarbanes-Oxley Act for destroying a “tangible object” that would have incriminated him, but justices ruled that two-word phrase should apply only to papers and electronic files.

“It’s not uncommon for the court to weigh in on a decision that can hinge on one word, two words or a handful of words,” Rublin said.

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