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'Obamacare' back at Supreme Court, with billions for insurers on the line

Phil Galewitz, Kaiser Health News on

Published in Health & Fitness

WASHINGTON -- More than $12 billion is at stake for the nation's health insurers Tuesday when the Supreme Court hears another Affordable Care Act case.

For the federal government, the potential damages could be far greater, as its reputation as a reliable partner to private businesses is on the line.

Unlike earlier Obamacare cases before the high court -- where the entire 2010 law and health coverage for millions of Americans was at risk -- the latest case has largely flown under consumers' radar.

The case revolves around a temporary "Obamacare" provision -- called the "risk-corridor" program -- that was designed to help health plans recover some losses in the first three years of the health law marketplaces.

The Republican-controlled Congress in late 2014 stripped most of the money out of the program in a budget bill signed by President Barack Obama. This occurred a year after insurers began selling policies to millions of Americans with the expectation that the safeguard would back them up.

Republicans led by Sen. Marco Rubio, R-Fla., who were determined to repeal the ACA, called the original provision an insurer "slush fund." But researchers later found that the loss of the risk-corridor program was largely responsible for soaring premiums in 2016 and 2017, and contributed to several startup insurers going out of business.

 

Dozens of insurers have cried foul and sued the government. Lower courts were split on whether the government should be forced to make the payments.

Here are five reasons you should pay attention to the case:

-- The integrity of the federal government is at stake.

Health insurers say the government's decision on the risk-corridor program amounts to a bait-and-switch. The health plans took a chance with the new marketplaces, where they had little knowledge of how sick or expensive new enrollees would be. They said they expected the risk-corridor funding would back them up.

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