It looked safe but wasn’t.
Shortfalls in the Feds’ “risk-corridor” program, meant to cut the financial risk of health plans on Affordable Care Act insurance exchanges by collecting funds from insurers doing a better exchange business and sharing the money with less successful ones, is not only famously hurting co-ops created under the ACA.
The government has said that it could pay only a small portion of what it owed in risk-corridor program payments.
But while co-ops have received most of the publicity about risk-corridor woes, small plans of all types are likely to face losses, Colorado HealthOP CEO Julia Hutchins told LifeHealthPro, linked here.
An example is a provider-owned health maintenance organization WINhealth, which has said it will quit Wyoming’s exchange in 2016 in part because of the uncertain status of its risk-corridor payments, LifeHealthPro reported.
Another example: When Pittsburgh-based Highmark Health announced losses in April, it cited negative results from selling Affordable Care Act health plans and uncertainty about the collectability of risk-corridor payments. So — not being confident about recouping the $155 million it was owed through the program — it took an “appropriately conservative accounting approach” concerning the payments.