Modern Healthcare

Risk corridor payment in full would be a quick fix for the ACA

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Regarding the recent article “Provider-sponsored insurance plans owed big risk-corridor payments” (ModernHeal­thcare.com, March 21) the risk-corridor payments were part of the Affordable Care Act and were included in the Congressio­nal Budget Office analysis that showed a net surplus for the ACA.

After the law was signed, Congress passed legislatio­n that limited how much money HHS could give to the insurers that had excess sick clients. That’s why the CMS paid only 12.6% of what the companies had been promised for 2014. When the insurers lost money, they had the choice of either exiting the market or hiking premiums—and that’s what they did. The co-op insurance companies were hit first and the hardest because they didn’t have the large capital that the major insurers have.

Obamacare is not in a death spiral, but this refusal to allow the law to work as intended has weakened it, and the Republican Congress is crowing about it. It’s like a 9-year-old tying his friend’s shoelaces and then laughing hysterical­ly when he stumbles.

If the risk-corridor payments were allowed to be paid in full, the exchanges would recover and be thriving. This is one of the ACA fixes that could easily be implemente­d with bipartisan amendments that would significan­tly improve today’s health insurance system.

David Matz, Ph.D. Chadds Ford, Pa.

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