The case could have important ramifications that have an impact on more than just insurers, said Timothy Jost, a health law expert and retired professor from Washington and Lee University in Lexington, Va.
“The insurers are left holding the bag, but a number of insurers went insolvent [due to the losses], so in those cases, the states are left holding the bag,” Mr. Jost said in an interview.
The outcome could influence future partnerships between the federal government and private entities, according to Katie Keith, an attorney and health law analyst who writes for the Health Affairs Blog. She noted that the U.S. Chamber of Commerce, which historically has not supported the ACA, sided with insurers in the case. In a court brief, attorneys for the chamber wrote that businesses make substantial financial investments to participate in federal programs, and their willingness to do so is based on having assurance that the government will honor its statutory commitments. If left uncorrected, the circuit’s decision “will have far-reaching consequences for myriad areas in which U.S. businesses partner with the federal government to provide vital goods and services,” chamber attorneys wrote.
“This is about more than the ACA. It’s about the fundamentals of public/private partnerships,” Ms. Keith said in an interview. “If you’re contracting with the government, can the government just break those promises or break those obligations after the fact? Folks at the chamber are making it about bigger, broader issues about what it means when the government partners with private organizations.”
Mr. Jost said it’s hard to say which way the Supreme Court will rule, but the fact that the court is reviewing the case speaks volumes.
“Its kind of hard to believe they’re going to order the federal government to pay $12 billion,” he said. “On the other hand, they didn’t have to take the case.”
A Supreme Court decision is expected in early 2020.