Monday, April 27, 2020

Federal "Risk Corridors" Insurer Payment Promises Under ACA Must Be Honored, By Trump. YAWN.


The nearly unanimous majority of the Supremes [in an 8-1 majority opinion] just rebuked Trumpists' claim that the federal government may retroactively disaffirm its prior contractual commitments. Commitments for which insurers are now "cash out of pocket" -- in specific reliance on those government promises.

Not at all surprising -- and perhaps more handwriting on the wall, that the other loony ACA challengers are in for a rough ride, later this fall, before the highest court. Here's a bit:

. . . .Section 1342 imposed a legal duty of the United States that could mature into a legal liability through the insurers’ actions -- namely, their participating in the healthcare exchanges. . . .

Nothing in §1342 requires the Risk Corridors program to be budget neutral, either. Nor does the text suggest that the Secretary’s payments to unprofitable plans pivoted on profitable plans’ payments to the Secretary, or that a partial payment would satisfy the Government’s whole obligation. Thus, without “any indication” that §1342 allows the Government to lessen its obligation, we must “give effect to [Section 1342’s] plain command.” Lexecon, 523 U. S., at 35. That is, the statute meant what it said: The Government “shall pay” the sum that §1342 prescribes. . . .

The Government’s arguments also conflict with well settled principles of statutory interpretation. At bottom, the Government contends that the existence and extent of its obligation here is “subject to the availability of appropriations.” Brief for United States 41. But that language appears nowhere in §1342, even though Congress could have expressly limited an obligation to available appropriations or specific dollar amounts. Indeed, Congress did so explicitly in other provisions of the Affordable Care Act. . . .

Section 1342’s mandatory “‘shall pay’ language” falls comfortably within the class of statutes that permit recovery of money damages in the Court of Federal Claims. This finding is bolstered by §1342’s focus on compensating insurers for past conduct. And there is no separate remedial scheme supplanting the Court of Federal Claims’ power to adjudicate petitioners’ claims. . . .


Onward. . . eight seven very important people just told Trump "shall" doesn't mean "maybe -- we will see what happens. . . ." Grin.

नमस्ते

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