A Washington, DC, court of appeals has determined consumers who purchase health insurance through the federal marketplace as opposed to state-run exchanges cannot receive subsidies. The Associated Press reports that the judges in the 2-1 decision in Halbig v Burwell supported a close reading of the law.

The lawsuit has been wending its way through the courts for a while, and, although it is being deliberated in several other venues, the decision is part of a legal dispute that puts patients in the 36 states offering federal exchanges in limbo.

The New York Times notes that the Obama administration has said the federal exchanges qualify as state exchanges because they were acting as state stand-ins. Dissenting appeals court judge Harry T. Edwards said Tuesday’s ruling was an “attempt to gut” the law and “defies the will of Congress.”

The AP notes that the three-judge lineup included George W. Bush appointee Thomas Griffith, George H. W. Bush appointee A. Raymond Randolph and Edwards, who was appointed by Jimmy Carter.