The Government Accounting Office says that the Barack Obama administration's subsidy system for money-losing health insurers is legal — for now. But depending on what Congress does with 2015 appropriations, it might not be legal next year.
For those who are confused, a little background. The Patient Protection and Affordable Care Act includes several reinsurance programs that were supposed to help insurers mitigate the risk of mispricing their policies as they ventured into the strange new world of selling insurance on the government exchanges. The administration is leaning hard on these programs to keep insurers in the game, allowing payments out to be higher than payments in, and otherwise substantially reducing the potential losses that insurers can experience when selling exchange policies. Critics have charged that they are doing this to keep policy prices artificially low for the remainder of Obama's term (these provisions expire in 2017).
The GAO just issued a new decision on the legality of these payments, in response to a query from Sen. Jeff Sessions, R-Ala., and Rep. Fred Upton, R-Mich. The GAO responded that the payments are indeed legal, but for them to be legal again in 2015, the appropriations language for 2015 would have to be similar to this year's language. In other words, the administration needs annual permission from Congress, in the form of appropriations; it can't just disburse the money based on the PPACA.
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