U.S. Supreme Court Rules That Feds Must Pay Insurers - Including Maine Co-op - Under ACA

Apr 28, 2020

The U.S. Supreme Court has found in favor of Maine's Community Health Options and other insurers that sued the federal government for failing to make payments under the Affordable Care Act.

The insurers were supposed to receive federal funding in the beginning years of the ACA under the risk corridor program to keep premiums low, says Community Health Options CEO Kevin Lewis. 

"We made good on our obligations in the first year, in 2014, when we actually turned a profit and were able to return some of that to the risk corridor program and to some of our members," Lewis says.

But Lewis says those payments ended after just one year. "It was very dismaying when we got to 2015 and realized the risk corridor program was a one-way street, apparently."

The co-op later struggled financially, triggering special oversight by Maine's Bureau of Insurance. Community Health Options is owed $59 million in lost funding.

This story was revised April 28, 2020 at 7:36 a.m. ET to reflect that the U.S. Supreme Court ruling affects other insurers, not just co-ops.