Skip to comments.Supreme Court to hear cases over ACA risk-corridor funds
Posted on 06/25/2019 5:07:57 PM PDT by spintreebob
The U.S. Supreme Court said on Monday it will take up cases over whether the federal government must pay billions of dollars to health insurers that sold coverage on the Affordable Care Act exchanges.
The Supreme Court will consider whether the government had an obligation to pay private health insurers under the so-called "risk corridor" program that was meant to offset insurer losses in the early years of the ACA exchanges. That three-year program has ended, but health insurers argue the HHS owes them more than $12 billion in unpaid funds.
The Supreme Court will hear three consolidated cases during its next term that starts in October.
The risk-corridor program was established under the ACA as a safety net that would curb losses and profits in the first three years of the health insurance exchanges. It was designed to discourage insurers from raising premiums because of uncertainty over who would enroll in their plans.
Plans with greater than expected medical claims could recoup some of those losses, while insurers with lower than expected costs would pay into the program. But Congress in 2014 passed a provision requiring the program to be budget-neutral, which led to a massive shortfall.
Health insurers sued to recover the payments they argue were promised. The federal government has argued that it is not obligated to make good on that promise because Congress limited what funds could go towards risk-corridor payments through appropriations riders.
Lower court decisions have been mixed. Most recently, the U.S. Court of Appeals for the Federal Circuit in November 2018 refused to rehear cases from Oregon's Moda Health Plan and Illinois' Land of Lincoln Mutual Health Insurance Co. after ruling in June that the federal government did not owe them money. Four plans, including Moda, Blue Cross and Blue Shield of North Carolina, Land of Lincoln, and Maine Community Health Options, then petitioned the Supreme Court in February to hear their cases.
What a colossal mistake it was for the Republican electorate to give the GOP controlled house and senate a pass for failing to fulfill the promise for a clean repeal.
There should have been torches and pitchforks but instead too many were willing to shrug their shoulders and say “Oh, well. We just didn’t have the votes!”.
At last we see why health providers backed Obamacare.
I’m sure the GOP-e would have found out eventually..../LOL
Make 0bama and H->! Pay.
WE ALL knew exactly why the insurance companies backed OCARE WE ALL knew there was some backroom deal cut with them!!! I hope SCOTUS tells them to hit the road it is a cost of doing business in a free market society!!! These insurance companies saw HUGE DOLLARS coming their way and most of their claims would have been fraudulent BECAUSE the government is SO EASY to file false claims and get paid BIG DOLLARS!!! This whole damn thing STINKS to high heaven!!!
SCOTUS needs to step up and become more productive and timely.
It has always been known. Most of the ACA was written by Big Pharma, J&J, etc. They used front men and women to deliver the document.
I would say that John McCain is a fu@king asshole, but I won’t because he’s dead.
The ACA was always designed to bilk taxpayer funds from the treasury AND individuals to the insurance providers, then those providers directed a percentage of that cash into Democratic coffers
Amazing the healthcare system worked before the jackass and his party of thugs saved us with a govt engineered pile of crap.
You shouldn't, because it would be grammatically incorrect. You should say "John McCain was a fucking asshole," because he was one.
I don’t read this as permanent just that they want to recoup the shortfall they were promised. If they were promised it they should get it paid. I don’t know if they are debating the amounts or the calculations or if the HHS is simply refusing to honor the commitment.
Just another headache over this debacle of a law that did not get anyone health care it only gave us mandatory health insurance premiums. Now they want to try again? I am amazed anyone still wants government to try again to get involved in healthcare. They cannot run the DMV. They cannot run the schools. They cannot run the border. They cannot run the HUD housing. The war on Drugs, the war on Poverty, the war on illiteracy are we “winning”?
The House has accomplished nothing but political attacks since the Dems took over, and Congress little even with the GOP in charge of it all. Why anyone would want th government to manage anything anymore is beyond me.
well if the health insurance companies wipe out HHS then there’s less money for invaders
I received two Republican policy surveys (with requests for money) this month. They always ask, “Should we repeal and replace Obamacare?”
Repeal, yes, replace, no. But the latter part is not an option.
That GD Obamacare is still haunting us.
That absolute creep in the office for eight agonizing years, and we, shlebs never raided the White House in order to save the country.
I should have acted!!!
If I’m reading correctly, they’re not asking to extend the duration of the payments, just trying to collect the amount defined in the ACA, which Congress then decided not to appropriate for.
If it isn’t appropriated then it is as binding as a campaign promise. And we know what they are worth in Congress.
Even in appropriations, they can be reversed.
If a man disabled with a hangnail is promised disability and then the caseworker reneges, does he have a case?
A promise from a politician is meaningless. I manage a CMS financed contract, $100Million to a big IT company. My boss can cancel that contract with any or no excuse given.
I don’t know the details of your contract - clearly you think it gives them an escape clause. Most agreements have a term and a termination component. I am aware of the unreliability of politicians but this is our government. The insurance companies have a case imo. They were induced to offer insurance policies they didn’t want to offer on the promise of reimbursement for a period of X (3?) years. They did their end of the deal, they should be reimbursed.
This doesn’t mean I like the deal or the ACA, only a question of being honorable to the word of the deal.
The newspapers say the 30,000+ moms, babies and disabled have been thrown off Medicaid in GA when they had contracts with GA to received Mecdicaid. Should we apply welfare to the rich and welfare to the poor equally? Of course, the reality is that one group has a better set of lawyers.
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