Maine Community Health Options v. United States

Maine Community Health Options v. United States
Supreme Court of the United States
Argued December 10, 2019 Decided April 27, 2020
Full case name	Maine Community Health Options v. United States
Docket no.	18-1023
Citations	590 U.S. ___ (more) 140 S. Ct. 1308
Case history
Prior	Land of Lincoln Mut. Health Ins. Co. v. United States, 129 Fed. Cl. 81 (2016); affirmed, 892 F.3d 1184 (Fed. Cir. 2018) Moda Health Plan, Inc. v. United States, 130 Fed. Cl. 436 (2017); reversed, 892 F.3d 1311 (Fed. Cir. 2018) Blue Cross & Blue Shield of N. Carolina v. United States, 131 Fed. Cl. 457 (2017); affirmed, 729 F. App'x 939 (Fed. Cir. 2018) Maine Cmty. Health Options v. United States, 133 Fed. Cl. 1 (2017); affirmed, 729 F. App'x 939 (Fed. Cir. 2018) Rehearing en banc denied, 908 F.3d 738 (Fed. Cir. 2018) Cert. granted, 139 S. Ct. 2743 (2019)
Holding
The Risk Corridors statute created a Government obligation to pay insurers the full amount set out in §1342’s formula Congress did not impliedly repeal the obligation through its appropriations riders. Petitioners properly relied on the Tucker Act to sue for damages in the Court of Federal Claims. .
Court membership
Chief Justice John Roberts Associate Justices Clarence Thomas · Ruth Bader Ginsburg Stephen Breyer · Samuel Alito Sonia Sotomayor · Elena Kagan Neil Gorsuch · Brett Kavanaugh
Case opinions
Majority	Sotomayor, joined by Roberts, Ginsburg, Breyer, Kagan, Kavanaugh; Thomas, Gorsuch (all but Part III–C)
Dissent	Alito
Laws applied
Patient Protection and Affordable Care Act; Tucker Act

Maine Community Health Options v. United States, 590 U.S. ___ (2020), was a United States Supreme Court case involving the expired Risk Corridors program of the Patient Protection and Affordable Care Act (ACA), through which the Department of Health and Human Services (DHHS) mitigated losses of unprofitable healthcare plans through the profits of the profitable plans during the first three years of the program. Congress had passed legislation as riders in appropriations bills, which prevented the government from making payments to the unprofitable plans. Several of the insurers went bankrupt from the lack of payment, and multiple insurers sued the government to recover their funds on the basis the risk corridor was a commitment to be paid. The Federal Circuit Appeals Court rejected those claims, concluding that the subsequent appropriation riders absolved the government of its responsibility to pay. In the 8–1 decision that consolidated three of the subsequent appeals, the Supreme Court ruled that Congress's riders did not cancel the government's obligation under the ACA to pay the full amount to the unprofitable plans, and that the insurers had properly sought relief through a Tucker Act action in the Court of Federal Claims.^[1]