Document ID: ./input/supremecourt_opinions/opinions/19pdf/18-1023_m64o.pdf
Page Number: 9

Cite as:  590 U. S. ____ (2020) 

5 

Opinion of the Court 

budget  neutrality.  Nine  months  before  the  program 
started,  HHS  acknowledged  that  the  Risk  Corridors  pro-
gram  was  “not  statutorily  required  to  be  budget  neutral.” 
78  Fed.  Reg.  15473  (2013).  HHS  assured,  however,  that 
“[r]egardless of the balance of payments and receipts, HHS
will remit payments as required under Section 1342 of the 
Affordable Care Act.”  Ibid. 

Similar  guidance  came  from  the  Centers  for  Medicare 
and Medicaid Services (CMS), the agency tasked with help-
ing  the  HHS  Secretary  collect  and  remit  program  pay-
ments.  CMS confirmed that a lack of payments from prof-
itable plans would not relieve the Government from making 
its  payments  to  the  unprofitable  ones.  See  79  Fed.  Reg.
30260  (2014).  Citing  “concerns  that  risk  corridors  collec-
tions may not be sufficient to fully fund risk corridors pay-
ments” to the unprofitable plans, CMS declared that “[i]n 
the unlikely event of a shortfall . . . HHS recognizes that the 
Affordable  Care  Act  requires  the  Secretary  to  make  full 
payments to issuers.”  Ibid. 

C 
The program’s first year, 2014, tallied a deficit of about 
$2.5  billion.    Profitable  plans  owed  the  Government  $362
million,  while  the  Government  owed  unprofitable  plans 
$2.87 billion.  See CMS, Risk Corridors Payment Proration 
Rate for 2014 (2015).

At the end of the first year, Congress enacted a bill ap-
propriating  a  lump  sum  for  CMS’  Program  Management. 
See  Pub. L. 113–235, Div. G, Tit. II, 128 Stat. 2130–2131 
(providing for the fiscal year ending September 30, 2015).
The bill included a rider restricting the appropriation’s ef-
fect on Risk Corridors payments out to issuers: 

“None  of  the  funds  made  available  by  this  Act  . . .  or 
transferred from other accounts funded by this Act to 
the  ‘Centers  for  Medicare  and  Medicaid  Services—