Maine Community Health Options v. United States

Summarized by:

  • Court: U.S. Supreme Court Certiorari Granted
  • Area(s) of Law: Insurance Law
  • Date Filed: June 24, 2019
  • Case #: 18-1023
  • Judge(s)/Court Below: 892 F.3d 1311 (Fed. Cir. 2018).
  • Full Text Opinion

Whether a congressional intent derived from the legislative history of an appropriations rider can impliedly repeal a statutory payment obligation of the government.

The consolidated Petitioners consist of insurers who relied on the Affordable Care Act’s “risk corridors” program. This program mandated that the government pay calculated amounts to health insurers so that insurers would participate in newly created health benefit exchanges and not raise premiums for perceived uncertainties in the market. After insurers provided insurance through these exchanges for nearly a year, Congress enacted an appropriations bill with an appropriations rider prohibiting the Department of Health and Human Services (HHS) from using funds to make risk corridor payments. Petitioners filed suit to obtain these payments. The cases in the Court of Federal Claims culminated in the Federal Circuit’s governing decision in Moda Health Plan, Inc. v. United States. The Federal Circuit held that the risk corridors program created an obligation for the government to pay participating insurers but concluded that Congress’s appropriations rider extinguished such an obligation based on an intent derived from legislative history. Petitoners argue to the United States Supreme Court that the Federal Circuit’s decision conflicts with Court precedent related to the canon of statutory construction against implied repeals. Petitioners reason that the Federal Circuit Court misread Court precedent as requiring a search for congressional intent when precedent requires a focus on statutory text. Petitioners emphasize that the Federal Circuit’s misreading of implied repeals undermines reliability on the government as a business partner, which will harm government contractors, while further devastating the healthcare market.

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