U.S. Supreme Court to Decide ACA Risk Corridor Payment Obligations
The U.S. Supreme Court has scheduled argument in the pending health insurer Risk Corridor appeals. These cases are collection actions filed against the federal government on behalf of Affordable Care Act (ACA) Health CO-OPs and other health insurers seeking recovery of more than $10 billion in risk corridor payments owed to them by the federal government under the ACA cost-sharing provisions. Since mid-2016, more than 55 actions have been filed in the Federal Claims Court on behalf of health insurers, including two class actions. Several of the plaintiffs are failed ACA Health CO-OPs in receivership.
There have been five decisions on the merits in these cases, with the government prevailing in three of those cases and the plaintiffs prevailing in two. Four of the cases were taken up on appeal to the Court of Appeals for the Federal Circuit; the fifth was stayed following a reported decision on the merits.
On June 14, 2018, a three-judge panel for the Court of Appeals ruled that the federal government had no further obligation to make payments that were owed to health insurers under the ACA’s risk corridor program, finding that language in a subsequent appropriations bill was sufficient to end the statutory payment obligations. The court’s ruling reflected a split decision by the panel, with one justice issuing a strongly worded dissent.
The plaintiff-insurers filed Petitions for Re-Hearing En Banc, seeking review by all active judges on the court. Those petitions were denied. They then filed Petitions for Certiorari with the U.S. Supreme Court. Numerous amicus briefs were filed in support of the petitions. After taking the petitions to conference twice in two consecutive weeks, the Supreme Court granted certiorari on June 24, 2019, and the cases were consolidated for hearing. Briefing is ongoing, and argument is scheduled for December 10 at 10:00 a.m.
Staff Contact - Joni ForsytheNew Jersey GA Seeks Executive Director
The New Jersey Life & Health Insurance Guaranty Association is seeking a well-qualified candidate to fill the position of Executive Director. The anticipated start date is approximately the first quarter of 2020, with a reasonable transition period following. Responses and résumés should be submitted by November 1 to:
Cathy St. John
Prudential
50 W. State St., Suite 1116
Trenton, NJ 08608
[email protected]