Affordable Care Act: Difference between revisions

The [[Risk corridor|risk-corridor]] program was a temporary risk management device.<ref>{{citation |url=http://www.rubio.senate.gov/public/_cache/files/1dc92ef8-c340-4cfd-95c0-67369a557f1e/2AA5EF8F125279800BFABC8B8BA37072.05.24.2016-crs-rubio-memo-risk-corridors-1-5-16-1-redacted.pdf |title=Lawsuits to Recover Payments under the Risk Corridors Program of the Affordable Care Act |date=January 5, 2016 |access-date=February 11, 2017 |author=Legislative Attorneys, American Law Division |publisher=[[Congressional Research Service]] |page=6 |archive-date=February 24, 2021 |archive-url=https://web.archive.org/web/20210224021300/https://www.rubio.senate.gov/public/_cache/files/1dc92ef8-c340-4cfd-95c0-67369a557f1e/2AA5EF8F125279800BFABC8B8BA37072.05.24.2016-crs-rubio-memo-risk-corridors-1-5-16-1-redacted.pdf |url-status=live }}</ref>{{rp|1}} It was intended to encourage reluctant insurers into ACA insurance market from 2014 to 2016. For those years the [[Department of Health and Human Services]] (DHHS) would cover some of the losses for insurers whose plans performed worse than they expected. Loss-making insurers would receive payments paid for in part by profit-making insurers.<ref>{{citation |title=Trouble on the Exchanges – Does the United States Owe Billions to Health Insurers? |author=Nicholas Bagley |journal=New England Journal of Medicine |date=November 24, 2016 |doi=10.1056/NEJMp1612486 |pmid=27959725 |volume=375 |issue=21 |pages=2017–2019}}</ref><ref>{{citation |url=https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/faq-risk-corridors-04-11-2014.pdf |date=April 11, 2014 |title=Risk Corridors and Budget Neutrality |publisher=[[Centers for Medicare & Medicaid Services]] (CMS) |location=Washington, DC |access-date=February 11, 2017 |archive-date=March 13, 2021 |archive-url=https://web.archive.org/web/20210313153006/https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/faq-risk-corridors-04-11-2014.pdf |url-status=live }} [[Department of Health and Human Services]]</ref>{{attribution needed |date=July 2017}} Similar risk corridors had been established for the [[Medicare Part D|Medicare prescription drug benefit]].<ref>{{citation |title=Yes, Marco Rubio Led The Effort To End Obamacare's Health |date=December 15, 2015 |url=https://www.forbes.com/sites/theapothecary/2015/12/15/yes-marco-rubio-led-the-effort-to-end-obamacares-health-insurance-slush-fund/?sh=18f0f95b4688 |work=[[Forbes]] |access-date=February 10, 2017}}{{cbignore|bot=medic}}</ref>

Several insurers sued the government at the [[United States Court of Federal Claims]] to recover the funds believed owed to them under the Risk Corridors program. While several were summarily closed, in the case of ''[[Moda Health]] v the United States'', Moda Health won a $214-million judgment in February 2017. Federal Claims judge [[Thomas C. Wheeler]] stated, "the Government made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise. After all, to say to [Moda], 'The joke is on you. You shouldn't have trusted us,' is hardly worthy of our great government."<ref>{{citation |url=https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv0649-23-0 |title=Moda Health Plan, Inc. v. The United States |publisher=US Courts |date=February 10, 2017 |access-date=February 10, 2017 |pages=40 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308105404/https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv0649-23-0 |url-status=live }}</ref> Moda Health's case was appealed by the government to the [[United States Court of Appeals for the Federal Circuit]] along with the appeals of the other insurers; here, the Federal Circuit reversed the Moda Health ruling and ruled across all the cases in favor of the government, that the appropriations riders ceded the government from paying out remain money due to the insurers. The Supreme Court reversed this ruling in the consolidated case, ''[[Maine Community Health Options v. United States]]'', reaffirming as with Judge Wheeler that the government had a responsibility to pay those funds under the ACA and the use of riders to de-obligate its from those payments was illegal.<ref name=":1">{{Cite web |title=Maine Community Health Options v. United States |url=https://www.scotusblog.com/case-files/cases/maine-community-health-options-v-united-states/ |website=SCOTUSblog |access-date=2020-05-02 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308145808/https://www.scotusblog.com/case-files/cases/maine-community-health-options-v-united-states/ |url-status=live }}</ref>

One was that under the law, seniors could be denied care due to their age<ref>{{cite web |url=http://snopes.com/politics/medical/over75.asp |title=Seniors Beware |website=Snopes |date=August 23, 2012 |access-date=July 17, 2013 |archive-date=July 1, 2024 |archive-url=https://web.archive.org/web/20240701043153/https://www.snopes.com/fact-check/seniors-beware/ |url-status=live }}</ref> and the other that the government would advise seniors to end their lives instead of receiving care. The ostensible basis of these claims was the provision for an [[Independent Payment Advisory Board]] (IPAB).<ref name="salon08132013" /> IPAB was given the authority to recommend cost-saving changes to Medicare by facilitating the adoption of cost-effective treatments and cost-recovering measures when statutory expenditure levels were exceeded within any given three-year period. In fact, the Board was prohibited from recommending changes that would reduce payments before 2020, and was prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing.<ref>{{cite web |first1=Jack |last1=Ebeler |first2=Tricia |last2=Neuman |first3=Juliette |last3=Cubanski |title=The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending |url=http://kff.org/health-reform/issue-brief/the-independent-payment-advisory-board-a-new/ |publisher=[[Kaiser Family Foundation]] |date=April 13, 2011 |page=3 |access-date=November 27, 2013 |archive-date=March 1, 2021 |archive-url=https://web.archive.org/web/20210301060545/https://www.kff.org/health-reform/issue-brief/the-independent-payment-advisory-board-a-new/ |url-status=live }}</ref><ref>{{cite news |first=Jonathan |last=Cohn |url=https://newrepublic.com/blog/jonathan-cohn/87102/ipab-medicare-commission-repeal-ryan-schwartz |title=Here We Go Again, With the Death Panels |magazine=[[The New Republic]] |date=April 20, 2011 |access-date=March 10, 2017 |archive-date=September 22, 2015 |archive-url=https://web.archive.org/web/20150922221033/http://www.newrepublic.com/blog/jonathan-cohn/87102/ipab-medicare-commission-repeal-ryan-schwartz |url-status=live }}</ref>

In 2010, the [[Pew Research Center]] reported that 85% of Americans were familiar with the claim, and 30% believed it was true, backed by three contemporaneous polls.<ref>{{Cite journal |first=Brendan |last=Nyhan |title=Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate |journal=The Forum |volume=8 |issue=1 |year=2010 |doi=10.2202/1540-8884.1354 |url=http://www.dartmouth.edu/~nyhan/health-care-misinformation.pdf |citeseerx=10.1.1.692.9614 |s2cid=144075499 |access-date=July 1, 2013 |archive-date=June 4, 2019 |archive-url=https://web.archive.org/web/20190604135225/http://www.dartmouth.edu/~nyhan/health-care-misinformation.pdf |url-status=dead }}</ref> The allegation was named [[PolitiFact]]'s 2009 "Lie of the Year",<ref name="Not so" /><ref>{{Cite news |title=PolitiFact's Lie of the Year: 'Death panels' |publisher=[[PolitiFact]] |date=December 19, 2009 |url=http://politifact.com/truth-o-meter/article/2009/dec/18/politifact-lie-year-death-panels |first=Angie |last=Drobnic Holan |access-date=November 19, 2010 |archive-date=January 13, 2020 |archive-url=https://web.archive.org/web/20200113082025/https://www.politifact.com/truth-o-meter/article/2009/dec/18/politifact-lie-year-death-panels/ |url-status=live }}</ref> one of [[FactCheck.org]]'s "whoppers"<ref>{{Cite news |title=False Euthanasia Claims |first1=Jess |last1=Henig |first2=Lori |last2=Robertson |publisher=[[FactCheck.org]] |date=July 29, 2010 |url=http://www.factcheck.org/2009/07/false-euthanasia-claims |access-date=July 20, 2013 |archive-date=February 24, 2021 |archive-url=https://web.archive.org/web/20210224220630/https://www.factcheck.org/2009/07/false-euthanasia-claims/ |url-status=live }}</ref><ref>{{cite web |title=Whoppers of 2009—We review the choicest falsehoods from a year that kept us busy |date=December 24, 2009 |author=Robertson, Lori |url=http://www.factcheck.org/2009/12/whoppers-of-2009 |publisher=[[FactCheck.org]] |access-date=April 28, 2011 |archive-date=March 10, 2021 |archive-url=https://web.archive.org/web/20210310232257/https://www.factcheck.org/2009/12/whoppers-of-2009/ |url-status=live }}</ref> and the most outrageous term by the [[American Dialect Society]].<ref>{{cite web |url=http://www.americandialect.org/2009-Word-of-the-Year-PRESS-RELEASE.pdf |title={{-'}}Tweet' 2009 Word of the Year, 'Google' Word of the Decade, as voted by American Dialect Society |date=January 8, 2010 |publisher=[[American Dialect Society]] |access-date=October 8, 2010 |archive-date=April 12, 2019 |archive-url=https://web.archive.org/web/20190412061753/http://www.americandialect.org/2009-Word-of-the-Year-PRESS-RELEASE.pdf |url-status=live }}</ref> [[AARP]] described such rumors as "rife with gross—and even cruel—distortions".<ref name="snopes1" />