HHS opens door to extra funds for insurers

Getty Images

Health insurance companies can count on funds from the government if ObamaCare's risk corridor program does not sufficiently cover losses that are higher than expected this year.

This news was published in regulations Friday outlining how the law's health insurance exchanges will operate in 2015.

ADVERTISEMENT
The risk corridors are designed to stave off premium increases by transferring money from insurers that see better-than-expected results to those that see worse-than-expected results.

The Obama administration had previously said the temporary program would be implemented in a budget-neutral way, without separate government funding. But federal health officials appeared to step back Friday from that promise, which was made under heavy criticism from Republicans who call the risk corridors a "bailout" for insurance companies.

"We anticipate that risk corridors collections will be sufficient to pay for all risk corridors payments," federal health officials wrote in a 436-page rule.

"That said ... in the unlikely event of a shortfall for the 2015 program year ... [the Department of Health and Human Services] will use other sources of funding for the risk corridors payments."

The rule noted that the Affordable Care Act "requires the Secretary to make full payments to issuers." It also stipulated that additional funding would only be appropriated if necessary and "subject to the availability of appropriations."

The language was first reported by The Washington Examiner, and is sure to spark criticism from congressional Republicans eager to use the program as a means to hammer the White House.

Insurance companies are typically allied to the right, though the implementation of ObamaCare has created distance between the industry and Republicans.

GOP lawmakers like Sen. Marco Rubio (Fla.) have stoked the fires by introducing legislation that would repeal the risk corridors, a common policy tool with wide support among insurers.

Friday's rule also formalized plans to tinker with the program by increasing how much insurers can pay to and receive from it this year.

In another attempt to stave off premium hikes, the rule proposed to lower the cost threshold for determining when the Health Department will chip in to pay for the care of especially sick patients.

That threshold, known as the "attachment point," will be lowered from $70,000 to $45,000, regulators said.

The rule also included new details on the small-business health insurance exchange and additional standards for navigators, the people who help consumers compare health plans.