For the fifth time, the ACA was under the microscope of the U.S. Supreme Court, but this time the court was looking at Republicans efforts to dismantle the law and their effects.
When Obamacare was enacted, the government promised to partially re-imburse insurance companies if they lost money because of the pre-existing conditions provision. The law stated that the government “shall” make these payments. But in 2015, Republicans attached riders to these appropriations bills that barred these promised payments.
The consequences were profound. By 2017 three-quarters of the original insurance providers were out of business, and several others stopped participating, leaving just six insurance providers and skyrocketing costs.
The insurers had lost out on $12 billion in promised payments. Lawyers for the insurers told the court of a massive “bait and switch” where the government had not upheld their end of the deal to the detriment of the companies and their insured members.
Chief Justice John Roberts suggested insurance companies were “seduced” into the programs and should have insisted on an appropriations provisions in the law.
TheTrump administration’s Deputy Solicitor General Edwin Kneedler then defended the refusal to pay.
Justice Stephen Breyer asked, “Why does the government not have to pay its contracts just like anybody else?”
Justice Ruth Bader Ginsberg noted there were insufficient votes in Congress to negate the obligation of the law’s mandate.
Chief Justice Roberts added, “You don’t question that these insurance companies would not have participated in the risk corridor program, but for the government’s promise to pay.”
Justice Brett Kavanaugh’s contribution was that Congress could pass a law to state that it could promise to pay “subject to future appropriations.”
That “puts people on notice,” interjected Justice Elena Kagan. “It says this is not a guarantee.” And when that language is “not there, the government says we’re committed.”
Kagan confirmed that the insurance companies are obligated to pay into the program when they have excess profits.
“You pay in, that’s obligatory,” Kagan shot back, but if the government commits to paying out, it’s only “if we feel like it?” she said incredulously. “What kind of a statute is that?”
The Supreme Court decision on the case is expected by summer.
Source at NPR.