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6  MAINE COMMUNITY HEALTH OPTIONS v. UNITED STATES 

Opinion of the Court 

Program Management’ account, may be used for pay-
ments under section 1342(b)(1) of Public Law 111–148
(relating to risk corridors).”  §227, id., at 2491. 

The program’s second year resembled its first.  In Febru-
ary 2015, HHS repeated its belief that “risk corridors col-
lections w[ould] be sufficient to pay for all” of the Govern-
ment’s  “risk  corridors  payments.”  80  Fed.  Reg.  10779
(2015).  The agency again “recognize[d] that the Affordable 
Care Act requires the Secretary to make full payments to
issuers.”  Ibid.    “In  the  unlikely  event  that  risk  corridors 
collections”  were  “insufficient  to  make  risk  corridors  pay-
ments,” HHS reassured, the Government would “use other 
sources of funding for the risk corridors payments, subject
to the availability of appropriations.”  Ibid. 

The 2015 program year also ran a deficit, this time worth
about $5.5 billion.  See CMS, Risk Corridors Payment and 
Charge Amounts for the 2015 Benefit Year (2016).  Facing
a second shortfall, CMS continued to “recogniz[e] that the
Affordable  Care  Act  requires  the  Secretary  to  make  full 
payments to issuers.”  CMS, Risk Corridors Payments for 
2015, p. 1 (2016).  CMS also confirmed that “HHS w[ould] 
record risk corridors payments due as an obligation of the 
United  States  Government  for  which  full  payment  is  re-
quired.”  Ibid.  And at the close of the second year, Congress 
enacted another appropriations bill with the same rider as 
before.  See Pub. L. 114–113, §225, 129 Stat. 2624 (provid-
ing for the fiscal year ending September 30, 2016). 

The program’s final year, 2016, was similar.  The Govern-
ment owed unprofitable insurers about $3.95 billion more 
than profitable insurers owed the Government.  See CMS, 
Risk Corridors Payment and Charge Amounts for the 2016
Benefit  Year  (2017).  And  Congress  passed  an  appropria-
tions bill with the same rider.  See Pub. L. 115–31, §223, 
131 Stat. 543 (providing for the fiscal year ending Septem-
ber 30, 2017).