Document ID: ./input/supremecourt_opinions/opinions/19pdf/18-1023_m64o.pdf
Page Number: 6.0

2  MAINE COMMUNITY HEALTH OPTIONS v. UNITED STATES 

Opinion of the Court 

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  market-
places, the Act created several programs to defray the car-
riers’ costs and cabin their risks. 

Among  these  initiatives  was  the  “Risk  Corridors”  pro-
gram, a temporary framework meant to compensate insur-
ers for unexpectedly unprofitable plans during the market-
places’ first three years.  The since-expired Risk Corridors 
statute, §1342, set a formula for calculating payments un-
der  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 of the Affordable Care Act established a money-
mandating obligation, that Congress did not repeal this ob-
ligation, and that petitioners may sue the Government for
damages in the Court of Federal Claims. 

I 
A 
In 2010, Congress passed the Patient Protection and Af-
fordable  Care  Act,  124  Stat.  119,  seeking  to  improve  na-
tional  health-insurance  markets  and  extend  coverage  to
millions of people without adequate (or any) health insur-
ance.  To  that  end,  the  Affordable  Care  Act  called  for  the 
creation  of  virtual  health-insurance  markets,  or  “Health 
Benefit Exchanges,” in each State.  42 U. S. C. §18031(b)(1).