Document ID: ./input/supremecourt_opinions/opinions/19pdf/18-1023_m64o.pdf
Page Number: 7

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

3 

Opinion of the Court 

Individuals may buy health-insurance plans directly on an
exchange  and,  depending  on  their  household  income,  re-
ceive tax credits for doing so.  26 U. S. C. §36B; 42 U. S. C. 
§§18081,  18082.    Once  an  insurer  puts  a  plan  on  an  ex-
change,  it  must  “accept  every  employer  and  individual  in
the  State  that  applies  for  such  coverage,”  42  U. S. C.
§300gg–1(a), and may not tether premiums to a particular
applicant’s health, §300gg(a).  In other words, the Act “en-
sure[s] that anyone can buy insurance.”  King v. Burwell, 
576 U. S. 473, 493 (2015).

Insurance  carriers  had  many  reasons  to  participate  in
these  new  exchanges.    Through  the  Affordable  Care  Act,
they  gained  access  to  millions  of  new  customers  with  tax 
credits worth “billions of dollars in spending each year.”  Id., 
at 485.  But the exchanges posed some business risks, too—
including  a  lack  of  “reliable  data  to  estimate  the  cost  of 
providing care for the expanded pool of individuals seeking 
coverage.”  892 F. 3d 1311, 1314 (CA Fed. 2018) (case below 
in No. 18–1028). 

This uncertainty could have given carriers pause and af-
fected the rates they set.  So the Affordable Care Act created 
several risk-mitigation programs.  At issue here is the Risk 
Corridors program.1 

B 
The Risk Corridors program aimed to limit participating
plans’ profits and losses for the exchanges’ first three years 
(2014,  2015,  and  2016).    See  §1342,  124  Stat.  211,  42 
U. S. C. §18062.  It did so through a formula that computed
a plan’s gains or losses at the end of each year.  Plans with 
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1 The others were the “Reinsurance” and “Risk Adjustment” programs. 
The former ran from 2014 to 2016 and required insurers to pay premi-
ums into a pool that compensated carriers covering “high risk individu-
als.”  §1341, 124 Stat. 208, 42 U. S. C. §18061.  The latter is still in effect 
and annually transfers funds from insurance plans with relatively low-
risk enrollees to plans with higher risk enrollees.  See §1343, 124 Stat. 
212, 42 U. S. C. §18063.