Hartford-based Aetna has sued the federal government over reneging on promised payments meant to lower the cost of premiums on health insurance exchanges created by the Affordable Care Act.
Aetna’s lawsuit, filed Friday in the U.S. Court of Federal Claims, seeks $5.9 million in so-called cost-sharing-reduction (CSR) payments it did not receive for 2016 and 2017.
Congress created CSR payments to reimburse insurers participating on ACA exchanges, including Access Health CT, for reducing out-of-pocket expenses in their mid-tier “silver” plan offerings.
The Trump administration decided in 2017 to stop making the payments, citing a federal judge’s ruling that they were unconstitutional because Congress had not appropriated the funds.
Numerous other insurers have already sued the government for the same reason, and a number have had success in the same legal venue, and are seeking to collect more than $2 billion combined, Health Affairs reported last year.
Aetna’s lawsuit makes reference to those four cases, all of which are currently being appealed by the government.
Aetna pulled out of most public exchanges in 2017, calling the business unsustainable.
Source: Hartford Business