18 November, 2013

Obamacare's Creative, Or Illegal, Rule-Making - Bloomberg

Obamacare's Creative, Or Illegal, Rule-Making - Bloomberg: But it seems that the administration is looking for ways to sweeten the deal for insurers. Politico reports, “Administration officials say they can take care of that problem. They're going to look at ways to adjust special payment mechanisms built into Obamacare, called 'risk corridors,' that pay health plans if they have higher costs than they expected.”

I’ve been skeptical of the argument that the risk corridors will fix things; they’ll mitigate insurer losses if the patient mix is too sick, but they don’t turn losses into profit. It’s a mechanism meant to deal with individual insurers who miscalculate their actuarial risk, not a whole marketplace filled with sicker and older patients than expected.

But this is a bit different; the administration is clearly looking for a way to increase the payments so that they defray more of the unexpected costs. Only looking at the statute, I don’t see how they can. The language is extremely clear: