Senators Press for Answers from DOJ, HHS on Potential Multimillion Dollar Obamacare Insurance Bailout
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The letter states: "The health care law contained three risk mitigation programs, one of which is the temporary Risk Corridor Program. This program was originally intended to be implemented in a budget neutral manner. This intention was confirmed when
The letter discusses the use of the judgement fund to resolve claims filed against the government for non-payment under the RCP, concluding that "it would be inappropriate for the
In addition to the letter,
Full text of the letter is below:
Dear Attorney General Lynch, Secretary Burwell, and Administrator Slavitt,
We write to express our grave concerns regarding the potential participation of your departments in a multibillion dollar bailout of select health insurance companies through the Affordable Care Act's Risk Corridors Program (RCP).[1] We also seek an explanation regarding your understanding of the availability of funds to settle claims for payment under the RCP.
The health care law contained three risk mitigation programs, one of which is the temporary Risk Corridor Program. This program was originally intended to be implemented in a budget neutral manner. This intention was confirmed when
In a
In a
The memorandum then went on to address recent suits filed by insurance issuers in federal court regarding non-payment under the RCP, expressing that, "as in all cases where there is litigation risk, we are open to discussing resolution of those claims," and that "[w]e are willing to begin such discussions at any time."[6]
If "resolution of those claims" refers to settlement with payment from the
Finally, CRS also stated in a memorandum requested by
Consequently, it would be inappropriate for the
1. Does CMS believe that
1a. If not, how does CMS intend to make "resolution of th[e] claims" in the ongoing litigation matter?
1b. If so, what does CMS believe constitutes an appropriation from
2. Does CMS believe that the Consolidated Appropriations Act, 2016, Pub. L. No. 114-113, Div. H S. 225, 129 Stat. 2242, 2624, which explicitly prohibits payments under the RCP absent sufficient revenue generated from the RCP itself,[8] nevertheless still allows CMS to make payments to insurers seeking reimbursement pursuant to 42 U.S.C. S. 18062 despite RCP revenue shortfalls, either overtly or in resolution of claims against the government for non-payment?
2a. If so, by what authority and based on what appropriation does CMS believe it may make payments to insurers seeking reimbursement pursuant to 42 U.S.C. S. 18062 despite RCP revenue shortfalls, either overtly or in resolution of claims against the government for non-payment?
Thank you for your attention to this matter.
[1] 42 U.S.C. S. 18062.
[2]
[3] Id.
[4]
[5] Id.
[6] Id.
[7] See Memorandum from Legislative Att'ys, Am. Law Div., Cong. Research Serv. to Senator
[8] See Consolidated Appropriations Act, 2016, Pub. L. No. 114-113, Div. H S. 225, 129 Stat. 2242, 2624 (2016) ("None of the funds made available by this Act from the
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