Supreme Court to hear $12B ACA payment case

Health insurers will argue they are owed billions in ACA payments in hearings before the Supreme Court Dec. 10, according to NPR.

The case to be heard combines lawsuits from Moda Health Plan of Oregon, Maine Community Health Options, Blue Cross Blue Shield of North Carolina and defunct Land of Lincoln Mutual Health Insurance. However, the ruling will affect dozens of other lawsuits filed against the federal government, and if SCOTUS agrees with insurers, will require the federal government to release more than $12 billion in payments.

The lawsuits concern a temporary provision under the ACA called the risk corridors program. The program aimed to help health insurers offset some of the expected losses in the first three years of the ACA marketplace. However, much of the money was never received by payers after funds were stripped in a 2014 budget bill.

If the Supreme Court rules in favor of insurers, it will be a big win for commercial payers and possibly consumers, who may see rebates or lower premiums. However, NPR notes: "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."

More articles on payers:
Optum's 'city by city' healthcare strategy: 4 things to know
BCBS accuses Tennessee hospital of using 'suspicious' billing tactics
UnitedHealth says revenues will top $260B in 2020

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