Moda sees victory in U.S. Supreme Court ACA ruling
Portland's Moda Health Plan, battered in recent years by uncertain finances, stands to gain a substantial infusion of cash as a result of a U.S. Supreme Court decision that bolstered part of the Affordable Care Act.
The court's 8-1 ruling on Monday, April 27, held that insurers can collect the $12 billion spent on so-called "risk corridors," which were created to reimburse companies for money lost in the first three years after Congress approved the sweeping act.
Several health care experts said the effect of the decision will benefit companies, such as Moda, that remained in the federal health insurance marketplace long after others, citing lack of adequate payments, dropped out.
"Moda is among the companies that will definitely benefit from the Supreme Court's decision," said Michael Arrigo, managing partner in California-based No World Borders, which specializes in health care data, regulations and economics. "There is obviously a lot of money at stake here."
Justice Sonia Sotomayer, who wrote the majority opinion, said it relies on a "principal as old as the nation itself: the government should honor its obligations."
The ACA, passed by Congress and signed into law by then-President Barack Obama in 2010, guaranteed participating insurance companies that they would be protected, Sotomayer wrote, Congress' later decision to withdraw money for risk corridors notwithstanding.
In a lone dissent, Justice Samuel Alito said the decision amounts to a massive bailout "for insurance companies that took a calculated risk and lost. These companies chose to participate in an Affordable Care Act program that they thought would be profitable."
The Lund Report is a Portland Tribune news partner.
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