Supreme Court of the United States · Official docket →
Moda Health Plan, Inc. v. United States
Paid petition · United States Court of Appeals for the Federal Circuit, No. 2017-1994
Before the decision, about 5.1× the 4.1% base rate. The model weighted this up for counsel who has won certiorari before and a dissent in the court below (flagged in the petition).
Question presented
Consolidated with 18-1023. To encourage health insurers to offer insurance on newly created health benefit exchanges, and to keep premiums low, the federal government made an unambiguous statutory commitment: If the costs of claims under these new health insurance policies exceeded the premiums charged in the first three years, the government would reimburse insurers a specified percentage of the difference. Numerous health insurers, including petitioners, relied on that promise, joined the exchanges, set their premiums, and incurred significant losses in providing health coverage. Congress later enacted a series of appropriations riders restricting the sources of funds available to the Department of Health and Human Services ("HHS") to pay insurers what was owed, but never amended the underlying statute. A divided Federal Circuit panel agreed that the government's initial statutory commitment was unambiguous, but relied on legislative history to hold the appropriations riders had repealed the statutory guarantee. The net effect was a bait-and-switch of staggering dimensions in which the government has paid insurers $12 billion less than what was promised. The question presented is: Whether Congress can evade its unambiguous statutory promise to pay health insurers for losses already incurred simply by enacting appropriations riders restricting the sources of funds available to satisfy the government's obligation.
Counsel of record
For petitioner
Paul D. Clement
Clement & Murphy, PLLC
For respondent
Noel John Francisco
Jones Day
Argument & decision
Argued December 10, 2019 — Paul D. Clement · Edwin S. Kneedler. Audio and transcript
Decided April 27, 2020. Opinion by Sotomayor.
Proceedings
- May 29 2020JUDGMENT ISSUED.
- Apr 27 2020Judgment REVERSED and case REMANDED. Sotomayor, J., delivered the opinion of the Court, in which Roberts, C. J., and Ginsburg, Breyer, Kagan, and Kavanaugh, JJ., joined, and in which Thomas and Gorsuch, JJ., joined as to all but Part III–C. Alito, J., filed a dissenting opinion. VIDED.
- Dec 10 2019Argued. For petitioners: Paul D. Clement, Washington, D. C. For respondent: Edwin S. Kneedler, Deputy Solicitor General, Department of Justice, Washington, D. C. VIDED.
- Nov 05 2019Record from the U.S.C.A. Federal Circuit is electronic and located on Pacer.
- Oct 25 2019CIRCULATED
- Oct 23 2019Record requested from the U.S.C.A. Federal Circuit.
- Sep 13 2019SET FOR ARGUMENT on Tuesday, December 10, 2019. VIDED.
- Jun 24 2019Petition GRANTED. The petitions for writs of certiorari in No. 18-1023 and No. 18-1038 are granted. The cases are consolidated, and a total of one hour is allotted for oral argument. VIDED.
- Jun 24 2019Because the Court has consolidated these cases for briefing and oral argument, future filings and activity in the cases will now be reflected on the docket of No. 18-1023. Subsequent filings in these cases must therefore be submitted through the electronic filing system in No. 18-1023. Each document submitted in connection with one or more of these cases must include on its cover the case number and caption for each case in which the filing is intended to be submitted. Where a filing is submitted in fewer than all of the cases, the docket entry will reflect the case number(s) in which the filing is submitted; a document filed in all of the consolidated cases will be noted as “VIDED.” (July 17, 2019)
- Jun 17 2019DISTRIBUTED for Conference of 6/20/2019.
- May 28 2019DISTRIBUTED for Conference of 6/13/2019.
- May 28 2019Reply of petitioners Moda Health Plan, Inc., et al. filed. (Distributed)
- May 08 2019Brief of respondent United States in opposition filed. VIDED.
- Apr 01 2019Motion to extend the time to file a response is granted and the time is further extended to and including May 8, 2019.
- Mar 29 2019Motion to extend the time to file a response from April 8, 2019 to May 8, 2019, submitted to The Clerk.
- Mar 08 2019Brief amicus curiae of America's Health Insurance Plans filed.
- Mar 08 2019Brief amici curiae of 18 States and the District of Columbia filed.
- Mar 08 2019Brief amicus curiae of National Association of Insurance Commissioners filed.
- Mar 08 2019Brief amici curiae of Highmark Inc., et al. filed.
- Mar 08 2019Brief amicus curiae of Chamber of Commerce of the United States of America filed.
- Mar 08 2019Brief amici curiae of Economists, et al. filed. VIDED
- Mar 08 2019Brief amicus curiae of Blue Cross Blue Shield Association filed. VIDED
- Mar 08 2019Brief amicus curiae of The Association for Community Affiliated Plans filed.
- Mar 08 2019Amicus brief of 18 States and the District of Columbia not accepted for filing. (Corrected version submitted)
- Feb 27 2019Motion to extend the time to file a response is granted and the time is extended to and including April 8, 2019.
- Feb 25 2019Motion to extend the time to file a response from March 8, 2019 to April 8, 2019, submitted to The Clerk.
- Feb 21 2019Blanket Consent filed by Petitioners, Moda Health Plan, Inc., et al..
- Feb 04 2019Petition for a writ of certiorari filed. (Response due March 8, 2019)