The U.S. Court of Appeals for the Federal Circuit today affirmed a 2019 court order requiring the federal government to reimburse insurers for unpaid cost-sharing reductions provided through the Affordable Care Act’s health insurance exchanges in 2017 and 2018.

The court also held in a related case that the Court of Federal Claims Court “must reduce [an] insurers’ damages by the amount of additional premium tax credit payments that [an] insurer received as a result of the government’s termination of cost-sharing reduction payments.”  

Insurers use the ACA’s cost-sharing reductions, which the administration stopped reimbursing in 2017, to reduce out-of-pocket costs for low-income individuals purchasing coverage through the exchanges. 

The court held that the government has “an unambiguous obligation” to reimburse the money, which is enforceable through a damages action in the Court of Federal Claims. 

Related News Articles

Perspective
“Don’t let perfect be the enemy of the good” is a quote credited to the French writer and thinker Voltaire. Although he died in 1778, that phrase is very…
Headline
The U.S. Supreme Court today heard oral argument in the latest challenge to the Affordable Care Act. The 5th Circuit Court of Appeals last year ruled the ACA’s…
Headline
In this AHA blog post, Sean Marotta, AHA outside counsel, shares five things to look for when the Supreme Court hears oral argument Nov. 10 in the latest…
Blog
The U.S. Supreme Court Nov. 10 will hear oral argument in California v. Texas, the latest challenge to the Affordable Care Act.  The plaintiffs —…
Headline
AHA General Counsel Melinda Hatton interviews Cate Stetson, acclaimed advocate and leader of the appellate practice at Hogan Lovells, about the U.S. Supreme…
Headline
Government Accountability Office agents made 31 covert phone calls to selected sales representatives in five states between November 2019 and January 2020,…