The Washington PostDemocracy Dies in Darkness

Supreme Court to consider whether federal government owes billions to health-care insurers

June 24, 2019 at 9:50 a.m. EDT
(Ricky Carioti/The Washington Post)

The Supreme Court will review another controversy involving the Affordable Care Act, the justices announced Monday, this one involving health-care insurers who say the federal government owes them billions of dollars.

The program, creating what is known as “risk corridors,” was one of three strategies built into the 2010 health-care law to try to deter insurers participating in the new marketplaces from mainly seeking customers who are healthy and thus use little medical care.

But insurers say the government never fully funded the program, and owes them $12 billion.

“That $12 billion error alone cries out for this court’s review,” said a brief filed by Moda Health Plan and Blue Cross and Blue Shield of North Carolina.

“But the consequences of the divided decision extend much further. By giving judicial approval to the government’s egregious disregard for its unambiguous statutory and contractual commitments, the decision provides a roadmap for the government to promise boldly, renege obscurely, and avoid both financial and political accountability for depriving private parties of billions in reliance interests.”

The risk corridors program was designed for the health exchanges’ initial years. It was supposed to help insurers with costs that are substantially greater than they expected. Originally, the program was not required to pay for itself, but, in a 2015 funding bill, congressional Republicans prohibited the Health and Human Services department from using any of its other resources for the program.