Maine Community Health Options v. United States
U.S. Supreme Court · decided April 27, 2020 · Supreme Court Database (Spaeth)
- Decided
- April 27, 2020
- Term
- October Term 2019
- Vote
- 8–1
- Majority author
- Justice Sotomayor
- Issue area
- Economic Activity
- Disposition
- Reversed and remanded
- Outcome
- Petitioning party won
- Ideological direction
- Conservative
Opinion excerpt
Justice SOTOMAYOR delivered the opinion of the Court. The Patient Protection and Affordable Care Act expanded healthcare coverage to many who did not have or could not afford it. The Affordable Care Act did this by, among other things, providing tax credits to help people buy insurance and establishing online marketplaces where insurers could sell plans. To encourage insurers to enter those marketplaces, the Act created several programs to defray the carriers' costs and cabin their risks. Among these initiatives was the "Risk Corridors" program, a temporary framework meant to compensate insurers for unexpectedly unprofitable plans during the marketplaces' first three years. The since-expired Risk Corridors statute, § 1342, set a formula for calculating payments under the program: If an insurance plan loses a certain amount of money, the Federal Government "shall pay" the plan; if the plan makes a certain amount of money, the plan "shall pay" the Government. See § 1342, 124 Stat. 211-212 (codified at 42 U.S.C. § 18062 ). Some plans made money and paid the Government. Many suffered losses and sought reimbursement. The Government, however, did not pay. These cases are about whether petitioners-insurers who claim losses under the Risk Corridors program-have a right to payment under § 1342 and a damages remedy for the unpaid amounts. We hold that they do. We conclude that § 1342…
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