The U.S. House of Representatives has weighed in on a high-stakes legal battle over whether the federal government owes health insurance companies billions of dollars under an Affordable Care Act program designed to encourage participation in the public exchanges. It isn't siding with the insurers.
The governmental body on Monday asked for permission from the U.S. Court of Appeals for the Federal Circuit to file an amicus brief urging affirmance of a lower court ruling in a case involving failed Chicago-based health insurer Land of Lincoln Mutual Health Insurance Co.
Land of Lincoln Mutual, a nonprofit, member-owned Consumer Operated and Oriented Program carrier, last June accused the U.S. Department of Health and Human Services of failing to make good on its obligation to pay more than $75 million under the ACA risk corridors program.
The ACA provision that created the program calls for the program to offset losses of struggling insurers that sell coverage through the public exchange system with funds collected from more profitable exchange plan issuers.
"The House has a strong interest in affirmance of the judgment below, which is necessary to vindicate one of Congress's core constitutional powers—the power of the purse," the motion states. The accompanying amicus brief is shielded from public view on PACER, the federal court document database system.
In his ruling rejecting Land of Lincoln Mutual's claim, Judge Charles Lettow of the U.S. Court of Federal Claims last November concluded that ACA public exchange issuer agreements describe how HHS thought the risk corridors program would work, but he said the agreements are not binding contracts. HHS officials, and the laws and rules governing the risk corridors program, have not provided any express intent on behalf of the government to enter into contracts with the exchange plan issuers, Lettow said.
