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(WBIR) Health insurance could no longer be affordable for Tennesseans who qualified for tax credits on the federal exchange.

A federal appeals court Tuesday struck down a key provision in the Affordable Care Act, a decision that could affect millions of low-and-middle income people in dozens of states, including Tennessee. That means premiums could potentially jump for more than 4.5 million people in 34 states, including Tennessee.

Eighty percent of the 151,352 Tennesseans who selected a plan between Oct. 1, 2013 and April 19, 2014 got financial assistance toward buying coverage, according to the U.S. Department of Health and Human Services.

In federal exchanges, people may qualify for subsidies from the IRS if they have incomes of up to $45,960 for individuals, $62,040 for couples, and up to $94,200 for a family of four.

The three-judges panel ruled the wording in the Affordable Care Act doesn't allow the Internal Revenue Services to provide tax credits to people who got insurance through federal exchanges. Without those subsidies, health insurance premiums could jump, making insurance not affordable.

The health care law only makes subsidies available to people who bought insurance through state-run exchanges, the U.S. Court of Appeals for the District of Columbia Circuit determined Tuesday in a 2-1 ruling.

Tennessee is one of 34 states that doesn't have state-run exchanges. As it stands, only 16 states have set up state-exchanges.

But Tennesseans won't lose the credits any time soon because the final outcome will likely be in the hands of the U.S. Supreme Court. In another scenario, the full 11 members of the U.S. Court of Appeals for the District of Columbia Circuit could weigh in on the issue, reported The Tennessean.

The lawsuit was filed by a group of small business owners in Tennessee, Texas, Virginia and West Virginia who objected to being required to buy insurance.

The decision, if upheld, would also mean that employers who use the federal exchange won't be penalized or fined if they don't provide insurance to their employees.

The Justice Department is expected to ask the entire appeals court to review Tuesday's decision.

Contributing: Tom Wilemon, The Tennessean

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