Illustration: Sarah Grillo/Axios

A group of insurers will make their case to the Supreme Court today for billions of dollars in Affordable Care Act payments.

Driving the news: The court will hear oral arguments in a long-running dispute over the ACA’s risk corridors program. Insurers say they’re owed billions of dollars from that program; the government says it doesn’t have to pay.

Why it matters: The implications for the ACA are modest, but it's a lot of money for these insurers — about $12 billion, all told.

Risk corridors were designed to even out the ACA’s early days. Insurers with a better-than-expected experience in the exchanges paid in, and that money was then paid out to insurers that had a worse-than-expected launch.

  • The amount the program was supposed to pay out exceeded the amount insurers had paid in. The assumption, at the time, was that the Department of Health and Human Services (HHS) would make up the difference itself.
  • But then Congress passed an appropriations rider saying HHS couldn’t use its own money to cover risk-corridors payments, leaving billions of dollars unpaid.

Insurers sued, claiming HHS had essentially reneged on a promise, only after insurers put themselves on the line in a new marketplace under the expectation that this safety net would be there.

The other side: The government argues that “Congress did not expose the federal fisc to that massive liability” — that it never intended to create an open-ended expense “based on criteria that depended largely on the insurers’ own business judgments.”

Go deeper: The return of the ACA wars

Go deeper

The apocalypse scenario

Illustration: Aïda Amer/Axios

Democratic lawyers are preparing to challenge any effort by President Trump to swap electors chosen by voters with electors selected by Republican-controlled legislatures. One state of particular concern: Pennsylvania, where the GOP controls the state house.

Why it matters: Trump's refusal to commit to a peaceful transfer of power, together with a widely circulated article in The Atlantic about how bad the worst-case scenarios could get, is drawing new attention to the brutal fights that could jeopardize a final outcome.

Federal judge rules Trump administration can't end census early

Census workers outside Lincoln Center in New York. Photo: Noam Galai/Getty Images

A federal judge ruled late Thursday that the Trump administration could not end the 2020 census a month early.

Why it matters: The decision states that an early end — on Sept. 30, instead of Oct. 31 — would likely produce inaccuracies and thus impact political representation and government funding around the country.

Caitlin Owens, author of Vitals
2 hours ago - Health

Where bringing students back to school is most risky

Data: Coders Against COVID; Note: Rhode Island and Puerto Rico did not meet minimum testing thresholds for analysis. Values may not add to 100% due to rounding; Cartogram: Andrew Witherspoon/Axios

Schools in Southern and Midwestern states are most at risk of coronavirus transmission, according to an analysis by Coders Against COVID that uses risk indicators developed by the Centers for Disease Control and Prevention.

The big picture: Thankfully, schools have not yet become coronavirus hotspots, the Washington Post reported this week, and rates of infection are lower than in the surrounding communities. But that doesn't mean schools are in the clear, especially heading into winter.

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