Court Rejects Insurers Claims That They’re Owed Billions Under Health Law’s Risk Corridors Provision
The panel said the government doesn't have to pay insurers the money because Congress had taken action — after the health law's passage — requiring the program to be budget neutral year after year. The program in contention was aimed at enticing insurers into the market with promises of covering their financial risks.
The Wall Street Journal:
Federal Government Doesn’t Have To Pay Billions To Health Insurers, Court Rules
The federal government doesn’t have to pay insurers billions of dollars under an Affordable Care Act program aimed at enticing them into the markets by helping cover their financial risks, a divided federal appeals court ruled Thursday. In a case brought by Moda Health Plan Inc., the ruling is a blow to insurers hoping to recoup money they say they were owed under the 2010 health law. (Armour and Kendall, 6/14)
Politico:
Court: Federal Government Doesn’t Owe Insurers Obamacare Payments
A divided three-judge panel rejected claims from two Obamacare insurers that the federal government was required to make good on payments from a program meant to protect insurers who attracted customers who were sicker and more expensive than anticipated. The two insurers were seeking hundreds of millions of dollars in payments from Obamacare’s risk corridor program, and at least three dozen other insurers have filed similar lawsuits. In all, insurers say they’re owed more than $12 billion from the risk corridor program, a shortfall they have partially blamed for skyrocketing premiums and dwindling competition in the Affordable Care Act marketplaces. (Demko, 6/14)
The Hill:
Court Rules Insurers Not Entitled To ObamaCare Payments
“Congress clearly indicated its intent here,” the court ruled. “It asked GAO [the Government Accountability Office] what funding would be available to make risk corridors payments, and it cut off the sole source of funding identified beyond payments in. It did so in each of the three years of the program’s existence.” The insurers are likely to appeal and seek a review by the full court, rather than just a panel. If that doesn’t succeed, the next step would be an appeal to the Supreme Court. (Weixel, 6/14)
Modern Healthcare:
Feds Don't Owe Health Insurers Billions In ACA Risk-Corridor Funds, Appeals Court Rules
A federal appeals court on Thursday ruled that the U.S. government does not owe health insurers billions of dollars in unpaid risk-corridor funds meant to offset losses during the early years of the Affordable Care Act exchanges. Although more than three dozen insurers claimed the federal government owed them more than $12 billion in risk-corridor payments, a panel of judges from the U.S. Court of Appeals for the Federal Circuit determined the payments weren't necessary since Congress deemed the program had to be budget-neutral through appropriations riders. (Livingston, 6/14)
