Supreme Court to consider whether federal government owes billions to health-care providers
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Source: Washington Post
Courts & Law
Supreme Court to consider whether federal government owes billions to health-care providers
By Robert Barnes, Reporter covering the U.S. Supreme Court
June 24 at 9:50 AM
The Supreme Court will review another controversy involving the Affordable Care Act, the justices announced Monday, this one involving health-care providers 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 owe them $12 billion. ... That $12 billion error alone cries out for this courts 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 governments 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.
Robert Barnes has been a Washington Post reporter and editor since 1987. He joined The Post to cover Maryland politics, and he has served in various editing positions, including metropolitan editor and national political editor. He has covered the Supreme Court since November 2006. Follow https://twitter.com/scotusreporter
Read more: https://www.washingtonpost.com/politics/courts_law/supreme-court-to-consider-whether-federal-government-owes-billions-to-health-care-providers/2019/06/24/420c209e-9685-11e9-916d-9c61607d8190_story.html
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Supreme Court to consider whether federal government owes billions to health-care providers
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machoneman
(4,006 posts)elleng
(130,864 posts)the justices announced Monday, this one involving health-care providers who say the federal government owes them billions of dollars.'
mountain grammy
(26,618 posts)is part of the law.. contractually garanteed. Then Congress then reneges on their obligation, and the SC does what? We are a failed country..
Igel
(35,296 posts)The funding was assumed.
It wasn't included in the original law because political PTBs decreed that the ACA/HCRA would be revenue neutral given a pre-set baseline among. This would have blown a hole in the budget. Therefore, they put every funding source they could in the legislation and left out things that would have rendered the promise moot. (Things like savings from student loans--money was saved by moving student loans in-house to be a fully federal operation; however, no money was saved by the program, the savings were rolled into funding for the ACA.)
However, the Congress has routinely specified funding levels and then failed to meet them. I don't think that the special ed mandate, which was supposed to come with federal money to fund it, was ever fully funded. It's assumed states will fully implement the legislation, but to do so requires using a lot of local/state money. Courts have declared Congress sovereign when it comes to funding; a Congress cannot be bound by a previous Congress. I assume that's the way this suit will go, if precedent carries the day.
mountain grammy
(26,618 posts)I need to understand that better and not sure I ever will.
Mr.Bill
(24,280 posts)this was Marco Rubio's little trick to sabotage the ACA.
turbinetree
(24,695 posts)this should be laid at the feet of Rubio.........................
https://www.nytimes.com/2015/12/10/us/politics/marco-rubio-obamacare-affordable-care-act.html
RobinA
(9,888 posts)I don't completely understand this, but it looks like the government promised insurers money to not game the system, didn't pay the money due to an act of Congress, and now insurers everywhere are failing due not getting an influx of our tax dollars...oh wait, they aren't failing. Guess what insurers, government says a lot of things. While I think government should do what it says it's going to do, I have a hard time getting upset because companies didn't get this windfall. It's not like they earned it in the course of business.
Yo_Mama_Been_Loggin
(107,900 posts)Yonnie3
(17,430 posts)The actual hearing before the Supremes will be the LBN, not an announcement that they will hear the case.