No. 18-1028 In the Supreme Court of the United States ______________________ MODA HEALTH PLAN, INC., Petitioner, v. UNITED STATES, Respondent. _____________________ BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA, Petitioner, v. UNITED STATES, Respondent. ______________________ On Writ of Certiorari to the United States Court of Appeals for the Federal Circuit ______________________ BRIEF FOR PETITIONERS ______________________ CAROLINE BROWN PAUL D. CLEMENT BROWN & PEISCH PLLC Counsel of Record 1233 20th Street, NW ERIN E. MURPHY Suite 505 C. HARKER RHODES IV Washington, DC 20036 MICHAEL A. FRANCUS Counsel for Moda KIRKLAND & ELLIS LLP Health Plan, Inc. 1301 Pennsylvania Ave., NW Washington, DC 20004 (202) 389-5000
[email protected] Counsel for Petitioners August 30, 2019 QUESTION PRESENTED 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statutory commitment was unambiguous, but relied on legislative history to hold that the appropriations riders had repealed the statutory guarantee.