Document ID: ./input/supremecourt_opinions/opinions/19pdf/18-1023_m64o.pdf
Page Number: 1

(Slip Opinion) 

OCTOBER  TERM,  2019 

1 

Syllabus 

NOTE:  Where  it  is  feasible,  a  syllabus  (headnote)  will  be  released,  as  is 
being  done  in  connection  with  this  case,  at  the  time  the  opinion  is  issued. 
The  syllabus  constitutes  no  part  of  the  opinion  of  the  Court  but  has  been 
prepared  by  the  Reporter  of  Decisions  for  the  convenience  of  the  reader. 
See United States v. Detroit Timber & Lumber Co., 200 U. S. 321, 337. 

SUPREME COURT OF THE UNITED STATES 

Syllabus 

MAINE COMMUNITY HEALTH OPTIONS v. UNITED 
STATES 

CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR 
THE FEDERAL CIRCUIT 

No. 18–1023.  Argued December 10, 2019—Decided April 27, 2020* 

The  Patient  Protection  and  Affordable  Care  Act  established  online  ex-
changes  where  insurers  could  sell  their  healthcare  plans.   The  now-
expired “Risk Corridors” program aimed to limit the plans’ profits and 
losses during the exchanges’ first three years (2014 through 2016).  See 
§1342, 124 Stat. 211.  Section 1342 set out a formula for computing a 
plan’s gains or losses at the end of each year, providing that eligible
profitable plans “shall pay” the Secretary of the Department of Health 
and  Human  Services  (HHS),  while  the  Secretary  “shall  pay”  eligible 
unprofitable  plans.    The  Act  neither  appropriated  funds  for  these 
yearly payments nor limited the amounts that the Government might 
pay.  Nor was the program required to be budget neutral.  Each year, 
the Government owed more money to unprofitable insurers than prof-
itable insurers owed to the Government, resulting in a total deficit of 
more than $12 billion.  And at the end of each year, the appropriations 
bills  for  the  Centers  for  Medicare  and  Medicaid  Services  (CMS)  in-
cluded a rider preventing CMS from using the funds for Risk Corridors 
payments.    Petitioners—four  health-insurance  companies  that  claim
losses under the program—sued the Federal Government for damages 
in the Court of Federal Claims.  Invoking the Tucker Act, they alleged 
that §1342 obligated the Government to pay the full amount of their 

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* Together with No. 18–1028, Moda Health Plan, Inc. v. United States 
(see this Court’s Rule 12.4) and Blue Cross and Blue Shield of North Car-
olina v. United States (see this Court’s Rule 12.4); and No. 18–1038, Land 
of Lincoln Mutual Health Insurance Co. v. United States, also on certio-
rari to the same court.