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4  MAINE COMMUNITY HEALTH OPTIONS v. UNITED STATES 

Opinion of the Court 

profits  above  a  certain  threshold  would  pay  the  Govern-
ment, while plans with losses below that threshold would 
receive  payments  from  the  Government.    §1342(b),  124
Stat. 211.  Specifically, §1342 stated that the eligible prof-
itable plans “shall pay” the Secretary of the Department of
Health  and  Human  Services  (HHS),  while  the  Secretary
“shall pay” the eligible unprofitable plans.  Ibid.2 

When  it  enacted  the  Affordable  Care  Act  in  2010,  Con-
gress  did  not  simultaneously  appropriate  funds  for  the 
yearly payments the Secretary could potentially owe under
the Risk Corridors program.  Neither did Congress limit the
amounts that the Government might pay under §1342.  Nor 
did  the  Congressional  Budget  Office  (CBO)  “score”—that
is,  calculate  the  budgetary  impact  of—the  Risk  Corridors 
program.

In  later  years,  the  CBO  noted  that  the  Risk  Corridors
statute did not require the program to be budget neutral. 
The  CBO  reported  that,  “[i]n  contrast”  to  the  Act’s  other
risk-mitigation programs, “risk corridor collections (which
will be recorded as revenues) will not necessarily equal risk 
corridor payments, so that program can have net effects on 
the budget deficit.”  CBO, The Budget and Economic Out-
look: 2014 to 2024, p. 59 (2014).  The CBO thus recognized 
that “[i]f insurers’ costs exceed their expectations, on aver-
age, the risk corridor program will impose costs on the fed-
eral budget.”  Id., at 110. 

Like the CBO, the federal agencies charged with imple-
menting  the  program  agreed  that  §1342  did  not  require 
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2 If  a  health  insurance  plan  made  (or  lost)  up  to  3  percentage  points 
more  than  expected  in  a  plan  year,  the  plan  would  keep  the  gains  (or 
losses).    If  the  plan  made  (or  lost)  between  3  and  8  percentage  points 
more than predicted, it would give up half of the earnings (or would be
compensated for half of the shortfalls) exceeding the 3 percentage-point 
threshold.  If the gains (or losses) exceeded predictions by eight percent-
age points, the insurers would pay (or receive) 80 percent of the gains (or
losses) exceeding the 8 percentage-point mark.  See §1342(b), 124 Stat. 
211, 42 U. S. C. §18062(b).