The U.S. Supreme Court heard oral arguments Tuesday in a lawsuit brought by several Affordable Care Act marketplace insurers, including one from Maine.
Community Health Options is seeking $59 million in funding that the federal government owes them under the risk corridor program, says CEO Kevin Lewis. The program was designed to help insurers recoup some of their losses in the first few years of the ACA marketplace and keep premiums low.
But after the first year, Lewis says, the government refused to pay.
“Those losses were particularly damaging, and the fact that the risk corridor program wasn’t there as designed, as intended, as promised, was certainly felt perhaps more strongly by us than many others,” he says. “[With] the eventual failure of the risk corridor program to make good on its promise, we saw what happened in 2017-2018 with the pretty steep rise in premiums. So these things are connected.”
Financial struggles at Community Health Options prompted greater oversight by the Maine Bureau of Insurance in 2015, and the co-op exited the New Hampshire market in 2017.