The Republicans would not fund the ACA Risk Pools for $3 billion, so now they need $130 Billion

[Gary S]

Last edited Wed May 3, 2017, 03:16 PM - Edit history (2)

The Affordable Care Act included a premium stabilization provision ("risk corridors" 1) that was designed to help cap insurance companies' risk in this uncertain environment. If claims paid by an insurer exceed a certain level, the provision would kick in and the insurance company would get help covering its loss. When insurance companies submitted their bills under the Affordable Care Act’s risk corridor provision, the Republican controlled congress funded only $362 million of the $2.87 billion requested by insurers in 2014 2.

This single act of betrayal by the Republican controlled House (whereby the risk coverage that had been assured when they set their premiums was not paid) made it inevitable that ACA rates would rise, and that some insurers would withdraw their plans. Insurers had to increase their rates to cover the risk that the ACA said Congress would cover.

Republican betrayal continued in 2015 and 2106, such that the limited risk pool funds available in 2015 and 2016 were still being used to pay off 2014 obligations, and the U.S. Department of Health and Human Services notified insurers that they should anticipate no payments for the 2015 risk corridors 3.

So, Republicans paid only a portion of the risk payments in 2014, and none in later years. They told insurance companies to stop expecting payments in 2015 and 2016.

Fast forward to 2017. A lot more Republicans now understand the risk associated with health insurance benefits (especially existing conditions and no lifetime maximums), and now they are set to provide $130 Billion to cover their own risk pool over the next 10 years. 4

People don’t seem to know that the Affordable Care Act actually had the risk corridor mechanism (still does), and that had the Republican controlled House funded what the law called for, we would most certainly have had lower premiums and more choices under the Affordable Care Act in 2015 and beyond.

The Republican controlled House caused the ACA rate increases, and the withdrawal of insurers, by their refusal to make the ACA Risk Corridor payments. They didn't care about the people, or the insurance companies. All they wanted was for "Obamacare" to fail.






1 Public Law 111-148 Patient Protection and Affordable Care Act, Section 1342 . Establishment of risk corridors for plans in individual and small group markets"

2 www.law360.com “ACA Risk Corridor Funding Falls Short, Litigation Ensues”, Law360, New York (June 9, 2016, 10:57 AM EDT)

3 Health and Human Services Memo “Risk Corridor Payments for 2015”, September 9, 2016. https://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-Stabilization-Programs/Downloads/Risk-Corridors-for-2015-FINAL.PDF

4 www.cnn.com “Here's a list of what you need to know about health care", Phil Mattingly Profile
By Phil Mattingly, CNN May 1, 2017

[HoneyBadger]

1. How much would free single payer for all cost?

Because that is what we need.

[stuffmatters]

2. Why have Dems been so inept at explaining Repugs are responsible for higher premiums/coverage loss?

This has been going on for three years yet Dems rarely explain the Repugs have caused these
problems the Repugs condemn Obamacare for. It's just astonishing actually that so few Americans (Dems even and including the MSM) covey or even know this fact. It wasn't even emphasized in the election even tho Trump & the Repugs yelled about the imminent collapse, the "disaster" of Obamacare. A collapse the Repugs wholly engineered by sabotaging the Risk Corridor obligations/payments.

Could the DNC, DCCC, DSC whoever's in charge please hire a professional messenger to teach our Dem representatives and politicians how to talk clearly and effectively on the reality of Republican Cruelty towards Americans?