Federal regulators have released a set of “adjustment percentages” that could determine how easily struggling health insurers can get help from a major Patient Protection and Affordable Care Act (PPACA) insurer buffer program.
But the agency that put out the numbers, the Center for Consumer Information & Insurance Oversight (CCIIO), has not given any information about how much cash the program might actually have available to help health insurers.
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The risk corridors program is supposed to use cash from plans with high underwriting profit margins for the 2014, 2015 and 2016 plan years to help the insurers that had bad results.
The new list means that a health insurer in Arkansas, the state with the highest adjustment percentage, may be able to earn an underwriting profit margin as high as 14.35 percent for 2014 and still ask cash from the risk corridors program, if the program has any cash. In North Carolina, the cut-off will be 12.85 percent.
Health insurers in 15 other states may be able to ask for risk corridors program help if they have 2014 profit margins under 9 percent.
Health insurers in 11 states and the District of Columbia will be able to put in a risk corridors claim only if they have profit margins under 3 percent.
In the remaining 23 states, the risk corridors program access cut-offs will range from 5.81 percent to 8.98 percent.
At this point, however, a new federal law forbids CCIIO from using taxpayer money to supplement insurer contributions to the risk corridors program fund, and it’s not clear how many health insurers earned enough in 2014 to have to pay cash into the fund.