Appeals court upholds order to pay ACA cost-sharing reductions

The U.S. Court of Appeals for the Federal Circuit today a 2019 court order requiring the federal government to reimburse insurers for unpaid cost-sharing reductions provided through the Affordable Care Act鈥檚 health insurance exchanges in 2017 and 2018.
The court also held in a that the Court of Federal Claims Court 鈥must reduce [an] insurers鈥 damages by the amount of additional premium tax credit payments that [an] insurer received as a result of the government鈥檚 termination of cost-sharing reduction payments.鈥&苍产蝉辫;&苍产蝉辫;
Insurers use the ACA鈥檚 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 鈥渁n unambiguous obligation鈥 to reimburse the money, which is enforceable through a damages action in the Court of Federal Claims.