Just like Moda Health won $100 million regarding risk corridor payments, the same basis will apply here and the payments will at least be restored for this year. That’s my call. This is a breach of contract case, pure and simple.
I don’t know if they will prevail, but they should. These are funds that were promised, and are there to reimburse the insurers for lowering co-pays and deductibles for lower income Americans, which the insurers were (and still are) required to do by law. Without the funding, it’s an “unfunded mandate,” which Republicans usually rail against.
I am no fan of the health insurance companies, or the private health insurance model in general. But this seems like a pretty clear cut case of screwing with an industry in order to harm their customers and trying to leverage that harm for political purposes.
In the end, this requires a legislative solution. But in the meantime, I hope the court orders the payments to be made. It’s a matter of basic fairness, most importantly to the health care consumers who rely on these plans, and also to the insurers who are on the hook to provide the required cost-sharing subsidies to these consumers.
FYI: The states filing the suit are California, Connecticut, Delaware, Illinois, Iowa, Kentucky, Maryland, Massachusetts, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia and Washington, as well as the District of Columbia.
This is the key. It was an inducement for insurers to offer on the exchange. They then offered on the exchange and are contractually obligated to continue those policies until December 31, 2017. Trump can’t simply unilaterally change the contract terms that the insurers relied upon to offer on exchange.
Donald Trump going back on his word? Shut my mouth…and I do hope he gets a good “bench slap” out of this. He’s such a pathetic excuse for a human being, let alone a President.
The funds were promised but do the states have standing to make sure that they are delivered? Elsewhere, it was suggested that the insurance companies could file suit instead.
This language, the states argue, shows the President is not committed to his constitutional obligation to “faithfully execute” the Affordable Care Act.
I think we have a winner for “Understatement of the Day.” And we could add…“or any other obligation of the presidency or laws of the United States.”
I think so. CSRs were factored into the 2017 rates. There were three more months of payments to go. Even though the ACA is a federal law, state departments of insurance are tasked with enforcing that law at the state level. They had to enforce rates that factored in the CSRs. That puts states in a real bind. They still have to enforce the law as it’s written. That’s why their primary argument is Trump’s refusal to enforce federal law.
Lifting the heavy load…
Yes… Nineteen states led by California and New York doing the hard work to protect the laws of the people…
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~OGD~
Yes, yes get after it!! This is a great angle. Someone has to stand up to this useless jack azs. Worst pres ever. I can hardly wait till Mueller/Comey put these scum bags out of business. Hopefully we can fix what they have screwed up. Sick of this fake clueless jack azs of a fake Pres.
I am so sick of this lying pos and his band of criminals, can’t wait for them to go.