Supreme Court to hear cases over ACA risk-corridor funds
Supreme Court to hear cases over ACA risk-corridor funds
“The U.S. Supreme Court said 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.”
Letter to The Editor – Modern Healthcare Alert
If you are going to report on this particular incident with the Cromnibus Act which passed December 11, 2014, why not give the complete history of how the Risk Corridor Program was stymied?
Initially, then Budget Committee Republican Ranking Member Senator Sessions wrote a letter to the GAO asking whether the Risk Corridor payments were being appropriated correctly. In a letter back to Sessions the GAO said Agencies can only appropriate funds at the discretion of Congress. Funding had not been properly secured for the Risk Corridor Program. This effectively stopped any new funding from being used for the Risk Corridor Program; however, funding could be transferred from other healthcare programs.
With the aid of House Energy and Commerce Chair Fred Upton and House Appropriations Chair Jack Kingston, Section 227 was inserted into the Cromnibus Act.
“None of the funds made available by this act from the Federal Hospital Insurance Trust Fund or the Federal Supplemental Medical Insurance Trust Fund, or transferred from other accounts funded by this act to the “Centers for Medicare and Medicaid Services – Program Management “ account may be used for payments under section 1342(b)(1) of Public Law 111-148 (relating to risk corridors).”
This was far more nefarious than Congress as a whole making this budget neutral and its hides what Republican Senator Sessions, and House Representatives Upton, and Kingston did to sabotage the ACA, drive up premiums, bankrupt Coops, cause companies to leave the healthcare exchanges, and cause constituents to lose coverage.
Yes indeed, Congress did vote for the Cromnibus Act in the waning day(s) left before a government shut down. Section 227 was inserted during those last few days and more than likely overlooked in the process of passing a budget bill so the government would not shut down.
run75441 (Bill H)
Should these companies win at SCOTUS review, the costs and blame should be assigned to these three as their motives were “solely” party politics over country thereby penalizing citizens.
What is nefarious about stating clearly in an appropriations bill what the funds are not for? If Congress is appropriating money and have a good idea that the executive will take some of that money and use it for something Congress specifically does not wish to spend money on, it seems not nefarious to me to make the appropriation while making clear to the executive what the money is not for.
As for the risk corridors themselves, I am sympathetic to the insurers, but not so much for their customers. Underwriting this new market was very uncertain. But for the customer the situation is simply that they should have paid more. The claim that not funding the risk corridors drove up premiums is a sort of lie really….it just changed who was expected to stump up the cash to pay for the correct underwriting. If I want a $30,000 car and have $25,000, I don’t feel cheated if Congress doesn’t give $5000 to the dealer. Now if Congress tells the dealer to sell it to me anyway at $25,000 and they’ll make up the difference and then don’t follow through, well that’s not good. But even then, insurers have lots of government relations experts and they must have observed that ACA was not a bi-partisan bill and the risk corridors did not have permanent appropriations language.
Eric:
Section 227 was added well past the time the reviews were made and discussions had on the budget. The urgency in passage was to forestall shutting down the government. It was done in a partisan manner the same as the repeated attempts to repeal the ACA. It was a well hidden manuver meant to cause harm to the very constituents Upton, Kingston, and Sessions represent. The manner, the reasoning, and the maneuver was nefarious and meant to cause harm. There was no attempt to be bipartisan by Republicans which the Democrats did attempt with the Repubs when writing the ACA.
Congress did want to fund the Risk Corridor program whis the same as the on going (today) Risk Corridor program put in place for Part D by Republicans. The ACA Risk Corridor program was scored properly by the CBO to produce a surplus over the three years of its existeance for which remaining funds would go to the GF. Calling me a liar will not exactly put you in my good graces; but, it does show you do not know what you are talking about on the ACA. No one wants your sympathy and what they want is what a Congress and the President passed.
Premiums increased for everyone and not just a select few. Community rating did not go away and the increase was spread amongst everyone. The Risk Corridor programs were meant to allow healthcare insurance programs time to adjust to those million dollar patients they may get in one year which can not planned for in the start up . . . akin and similar to having an automobile accident.
One thing you do have correct, it was not a bi-partisan bill due to Republicans refusing, even before Barack Obama took office, to work with Democrats. Much to your liking, hey?