Insurers not entitled to $12B in risk corridors payments, DOJ says

The Department of Justice said health insurers shouldn't receive $12.3 billion in federal payments they expected to receive from selling plans on the ACA's individual marketplaces, according to The National Law Journal.

On May 8, Justice Department officials asked the U.S. Supreme Court to reject lawsuits from payers seeking the risk corridors payments. The temporary risk corridors program was designed to level the financial playing field for payers during the first three years of the ACA's implementation, 2014-16. Under the program, the government collected payments from insurers with lower than expected claims on the health insurance exchanges and made payments to insurers with higher than expected claims. 

However, department officials said the federal government is not required to make the payments because Congress took action to require the program be budget-neutral, though this action came after the ACA's passage.

The risk corridors program only paid 12.6 percent of payments it owed to health insurers in 2014.

More articles on payers:
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