Republicans continue to press the administration and HHS about what they say are illegal payments to insurers as part of the Affordable Care Act reinsurance program, according to The Hill.
Here are five things to know about the issue.
1. The reinsurance program is designed to offset the costs of insuring sicker enrollees in the early years of the ACA. In 2014, the program was supposed to collect $10 billion from payers to distribute among those plans with high-cost enrollees, and collect another $2 billion for the U.S. Treasury, according to the report.
2. Not enough money was collected in 2014. The administration prioritized payments to insurers in the hopes of keeping consumer premiums down. No payments were made to the U.S. Treasury in the first year, according to the report. HHS Secretary Sylvia Burwell said at a Senate Appropriations Committee hearing earlier this month that this decision was published for comment and no concerns were raised at that time, according to the report.
3. However, Republicans now say this is in conflict with plain reading of the ACA. They point to part of the bill that states the $2 billion "shall be deposited into the general fund of the Treasury of the United States and may not be used for the program established under this section [i.e. the payments to insurers]," according to the report. Concerns have been raised at various Senate hearings and this week Sens. Marco Rubio (R-Fla.) and Orrin Hatch (R-Utah) wrote a letter to Secretary Burwell calling the decision "unacceptable," according to the report.
4. HHS stands by its decision, as do other ACA supporters. Tim Jost of Lexington, Va.-based Washington and Lee University told The Hill he thought the decision was reasonable given the primary purpose of the reinsurance program is to even the playing field for insurers, not collect taxes. He said they were likely interpreting the law in a way that makes it work, according to the report.
5. Republicans from the Energy and Commerce committee are claiming the decision is due to a conflict of interest. They are making a link between the payments and former head of CMS, Marilyn Tavenner, who now is head of America's Health Insurance Plans, according to the report. Both Secretary Burwell and AHIP declined to comment on this matter, according to the report.
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