Aug 5, 2017

Insurer wins $52 million in ACA payment lawsuit

Andrew Harnik / AP

A federal judge ruled late Friday in favor of Molina Healthcare, declaring the health insurer is owed $52.4 million under the Affordable Care Act's risk corridor program, which was created to help insurance companies manage their unpredictable costs in the law's early years. Molina, which has been crushed by the ACA so far this year, filed suit in January after congressional Republicans blocked the payments, calling them a "bailout" for the industry.

The court opinion said the federal government was "liable for its breach of a statutory and contractual obligation" to make the payments to participating insurers.

Why it matters: Molina is now the second health insurer to win a risk corridor lawsuit, following Moda Health from earlier this year. But as legal expert Nicholas Bagley has pointed out, even with the court wins, health insurers may not be able to collect their risk corridor money until Congress appropriates funds — the same Congress that neutered the risk corridor payments.

Go deeper

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 10 p.m. ET: 857,957 — Total deaths: 42,139 — Total recoveries: 178,091.
  2. U.S.: Leads the world in confirmed cases. Total confirmed cases as of 10 p.m. ET: 188,547 — Total deaths: 3,899 — Total recoveries: 7,068.
  3. Business updates: Should you pay your rent or mortgage during the coronavirus pandemic? Find out if you are protected under the CARES Act.
  4. Public health updates: More than 400 long-term care facilities across the U.S. report patients with coronavirus — Older adults and people with underlying health conditions are more at risk, new data shows.
  5. Federal government latest: President Trump said the next two weeks would be "very painful," with projections indicating the virus could kill 100,000–240,000 Americans.
  6. Coronavirus in custody: Inmates in all U.S. federal prisons are set to enter a 14-day quarantine on April 1. A federal judge on Tuesday ordered U.S. Immigration and Customs Enforcement to release 10 detained immigrants who are at risk of contracting COVID-19 while in confinement.
  7. U.S.S. Theodore Roosevelt: Captain of nuclear aircraft carrier docked in Guam pleaded with the U.S. Navy for more resources after more than 100 members of his crew tested positive.
  8. What should I do? Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk.
  9. Other resources: CDC on how to avoid the virus, what to do if you get it.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.

World coronavirus updates: UN warns of recession with "no parallel" to recent past

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 and confirmed plus presumptive cases from the CDC

The novel coronavirus pandemic is the "greatest test" the world has faced together since the formation of the United Nations just after the Second World War ended in 1945, UN chief António Guterres said Tuesday.

The big picture: COVID-19 cases surged past 856,000 and the death toll exceeded 42,000 Tuesday, per Johns Hopkins data. Italy reported more than 12,000 deaths.

Go deeperArrowUpdated 2 hours ago - Health

White House projects 100,000 to 240,000 U.S. coronavirus deaths

President Trump said at a press briefing on Tuesday that the next two weeks in the U.S. will be "very painful" and that he wants "every American to be prepared for the days that lie ahead," before giving way to Deborah Birx to explain the models informing the White House's new guidance on the coronavirus.

Why it matters: It's a somber new tone from the president that comes after his medical advisers showed him data projecting that the virus could kill 100,000–240,000 Americans — even with strict social distancing guidelines in place.

Go deeperArrowUpdated 4 hours ago - Health