The US District Court for the District of Columbia has issued an opinion in United States House of Representatives v. Burwell, Civ. Action No. 14-1967 (RMC) (May 12, 2016), granting the House’s motion for summary judgment and enjoining further reimbursements under section 1402 of the Affordable Care Act (ACA). The court stayed its injunction pending appeal.
Section 1402 requires the Secretary of Health and Human Services (HHS) to reimburse issuers of qualified health plans for certain cost-sharing reductions of deductibles, coinsurance, copayments, and similar charges required to be made for insured individuals who are eligible to receive refundable premium tax credits under section 1401. The district court found that while the ACA expressly made a permanent appropriation for refunds of the premium tax credits under section 1401, it did not do so for reimbursements under section 1402. The court held that in the absence of such appropriation (or an annual appropriation from Congress), reimbursements paid out by the Secretaries of HHS and Treasury violated the Appropriations Clause of the Constitution.