Supreme Court Rebuffs Cost-Sharing Reduction Payment Appeal; $20 Million For State-Based Marketplaces

On June 21, 2021, the Supreme Court denied requests from multiple insurers to review lower court decisions that held they were not entitled to full unpaid cost-sharing reduction payments (CSRs). As a result, two August decisions by a three-judge panel of the Court of Appeals for the Federal Circuit will stand. Under these decisions, insurers are entitled to the unpaid CSRs, but the total amount they are owed must be offset by any excess premium tax credits received from premium loading for 2018 and beyond. From here, insurers and the federal government may negotiate settlements or pursue damages calculations before the Court of Federal Claims.

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