Republican Control of Congress Could Threaten ACA Program’s Funding, Industry Observers Tell AIS Newsletter

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A recent Government Accountability Office analysis and potential Republican takeover of the United States Senate could threaten risk-corridors program funding, reports Atlantic Information Services’s Inside Health Insurance Exchanges.

With a couple of weeks to go until the November midterm elections and polls predicting Republicans will win back the Senate, the risk-corridors program could be at risk, some industry observers tell Atlantic Information Services’s Inside Health Insurance Exchanges (HEX) in its Oct. 16 issue.

The three-year risk-corridors program provides funds to carriers on exchanges with a disproportionate share of high-cost enrollees through a fee on carriers with a lower-than-expected risk. A recent Government Accountability Office (GAO) opinion (B-325630) indicates that the Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid Services aren’t able to distribute funds for the risk-corridors program without appropriations authority from Congress. Despite the program being created as budget neutral, some conservatives have labeled the program a bailout for health insurers and are working to ensure that HHS doesn’t have funding for it.

“The risk-corridor payments are a big deal to the insurance carriers,” says Chris Condeluci, a principal at CC Law & Policy in Washington, D.C., and who served as tax counsel for the Senate Finance Committee during the crafting of the Affordable Care Act (ACA). “If these payments are not available, you will likely see double-digit premium increases and/or insurance carriers dropping out of exchange markets in droves.”

If Republicans do gain control of the Senate, the size of the majority could have an impact, says Timothy Jost, a law professor at Washington and Lee University. A Senate with a four- or five-seat majority, he tells HEX, would be more likely to take on the ACA than one with a smaller majority. He also suggests that a Republican-led Senate might not be in lockstep like the Republican-majority House.

Visit to read the article in its entirety, including more commentary from Jost, and from William Pewen, Ph.D., former senior health policy advisor to retired senator Olympia Snowe (R-Maine), who both called Republicans’ motives into question.

About Inside Health Insurance Exchanges
Inside Health Insurance Exchanges provides hard-hitting news and strategies on public and private health insurance exchanges, written for business leaders with health plans, pharma companies, hospitals and health systems, brokers and agents, and exchange managers and vendors. The newsletter delivers reliable intelligence on this critical cornerstone of health reform — the players and their partners, product designs and enrollment results, employer perspectives and much more. Visit for more information.

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at

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