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

Modern Healthcare - - COMMENT -

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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