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04/27/2020

SCOTUS Rules Government Must Pay Billions to ACA Insurers

The decision is a big win for health insurers

On Monday, the Supreme Court of the United States (SCOTUS) ruled the federal government owes health insurers massive payments from an Affordable Care Act (ACA) program shielding them from financial risks after the companies accused Washington of reneging on its funding promises.

The 8-1 decision could open the floodgates for federal cash to the insurance industry. Insurers who accused the government of a “bait and switch” claimed they’re owed $12 billion from the ACA program.

The case concerned a temporary fund in the health care law intended as a buffer for health plans who had sicker customers than expected in the newly overhauled insurance marketplaces. Obamacare’s drafters hoped the program would be funded by industry, but health plans quickly racked up losses when the marketplaces opened in 2014. The next year, Republican lawmakers approved the first in a series of annual appropriations riders barring HHS from using taxpayer dollars to bankroll the program, known as risk corridors.

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