1. “Whether the insurers’ statutory claims fail because Congress did not intend for insurers to receive damages as compensation for cost-sharing payments that Congress declined to fund.” 2. “Whether the insurers’ contract claims fail because insurers do not have implied-in-fact contracts for cost-sharing payments.”
“The government appeals. We consolidated the appeals, and we now affirm. After initial briefing and argument, the Supreme Court decided Maine Community Health Options v. United States, 140 S. Ct. 1308 (2020), addressing a different payment-obligation provision of the ACA. We conclude that Maine Community makes clear that the costsharing-reduction reimbursement provision imposes an unambiguous obligation on the government to pay money and that the obligation is enforceable through a damages action in the Court of Federal Claims under the Tucker Act, 28 U.S.C. § 1491(a)(1). We see no persuasive basis for distinguishing these cases from Maine Community.”
