Feb 9, 2017

Court rules insurer is owed Obamacare "risk corridor" money

The U.S. Court of Claims on Thursday ruled the U.S. government owes Moda Health, an Oregon health insurer, $214 million in unpaid Obamacare "risk corridor" money, The Oregonion reports. The ruling — which focuses on money to help insurers with expensive patients — could have significant consequences for pending cases brought by other insurers across the nation.

Although the risk corridor payments were part of the original health care law, Congress later passed legislation requiring the program to be budget-neutral, meaning it wouldn't have any net cost to the government. When insurers overall underestimated the cost of their enrollees, this meant plans altogether lost billions of dollars.

Thursday's ruling says despite the budget-neutral provision, insurers are still owed the money by law. "The Court finds that the Government made a promise in the risk corridors program that it has yet to fulfill," wrote Judge Thomas Wheeler. "To say to [Moda], 'The joke is on you. You shouldn't have trusted us,' is hardly worthy of our great government."

Why this matters: More than a dozen other lawsuits have been filed by insurers claiming they're owed the money. However, this is the first victory for a plan and follows an earlier defeat in a different case, Washington and Lee law professor emeritus Tim Jost tells me. Not only could this encourage other insurers to file lawsuits, but it also means judges have ruled differently on the issue. This will likely have to be resolved in a federal appeals court.

Go deeper

Bernie Sanders wins Nevada caucus

Democratic presidential candidate Sen. Bernie Sanders waves to supporters at a campaign rally on Friday in Las Vegas. Photo: Mario Tama/Getty Images

Sen. Bernie Sanders is projected to handily win the Nevada Democratic primary caucus, becoming the clear frontrunner among 2020 Democratic presidential primary election candidates.

Why it matters: Nevada is the first state with a diverse population to hold a nominating contest, highlighting candidates' abilities to connect with voters of color — particularly Latino voters.

Go deeperArrowUpdated 1 hour ago - Politics & Policy

South Korea and Italy see spikes in coronavirus cases

Data: The Center for Systems Science and Engineering at Johns Hopkins, the CDC, and China's Health Ministry. Note: China numbers are for the mainland only and U.S. numbers include repatriated citizens.

The novel coronavirus has spread to more nations, and the U.S. reports a doubling of its confirmed cases to 34 — while noting these are mostly due to repatriated citizens, emphasizing there's no "community spread" yet in the United States.

The big picture: COVID-19 has now killed at least 2,362 people and infected more than 77,000 others, mostly in mainland China. New countries to announce infections recently include Israel and Lebanon, while Iran reported its sixth death from the virus. South Korea's confirmed cases jumped from 204 Friday to 433 on Saturday and Italy's case count rose from 3 to 62 by Saturday.

Go deeperArrowUpdated 5 hours ago - Health

America's rundown roads add to farmers' struggles

Illustration: Sarah Grillo/Axios

American farmers are struggling to safely use the roads that cut through their fields; decades of neglect and lack of funding have made the routes dangerous.

The big picture: President Trump has long promised to invest billions in rural infrastructure, and his latest proposal would allocate $1 trillion for such projects. Rural America, where many of Trump's supporters live, would see a large chunk of that money.