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Wednesday, May 29, 2024 | Back issues
Courthouse News Service Courthouse News Service

House Boxed Out of Battle on Health Care Funding

     WASHINGTON (CN) — A federal judge looking at the funding lapse for insurers acclimating to the health care law has refused to let the U.S. House of Representatives intervene in the battle.
     The United States faces at least 11 lawsuits related to the risk-corridor program of the Patient Protection and Affordable Care Act.
     Meant to be a temporary program that ran from 2014 through 2016 — the first three years in which the Affordable Care Act was in place — risk-corridor benefits were supposed to help insurers set premiums in markets flooded with millions of new customers about whom companies had little to no information.
     The government was supposed to collect funds from insurers doing well, and make payments from that pool to those that are not. When funds owed to floundering insurers far surpassed what were collected, however, and Congress passed a December 2014 appropriations act that put risk-corridor funding in jeopardy.
     Insurers waiting on their past-due payments in turn went to the U.S. Court of Federal Claims.
     Judge Margaret Sweeney noted this week that the U.S. House of Representatives is seeking intervention in one such suit brought by a company called Health Republic Insurance.
     Though the Justice Department moved to dismiss this case in June, the House claims to have a separate argument for dismissal.
     It says the DOJ made a strong point in motions to dismiss four of the other risk-corridor cases, but failed to raise these same issues against Health Republic Insurance.
     The House wants to raise this point itself, but Sweeney shot the maneuver down Monday.
     "The DOJ has 'exclusive and plenary' control over the United States' defense of this litigation, foreclosing the ability of another government entity from acting on the United States' behalf," she wrote. "Thus, the House cannot separately assert a ground for dismissing plaintiff's complaint that was not raised by the DOJ, especially under the auspices of an amicus curiae brief."
     As summed up in the 5-page ruling, the unspoken bid for dismissal argues that the insurers do not have a right to receive "risk corridors payments in excess of program receipts."

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