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Episode description:

How did one article in the newspaper turn into a $12bn case? It starts with the Affordable Care Act, the “risk corridors program” incentivized insurers to enter the new health insurance marketplace by agreeing to backstop outsized losses in the first three years of the exchange’s existence. The Government was refusing to pay amounts in full, losses mounted, and bankruptcies stacked up across the health insurance industry and the country. One little article covering such a bankruptcy crossed JD Horton’s desk and…the rest (all $12 billion of it) is covered in this podcast!

In this episode of Law, disrupted, John joins Quinn Emanuel partners Stephen Swedlow & J.D. Horton, who led the recovery of billions of unpaid funds owed under the program in a case that went all the way to the US Supreme Court. In their discussion, they describe how they developed the statutory claim against the federal government under the Tucker Act, and reveal why health insurance companies were reluctant to sue the government and “bite the hand that feeds them.”

Highlighting some of the challenges and push-back that they faced along the way, Stephen talks about crisscrossing the country to get 150 entities to join the claim he and Horton were heading, despite competition from several leading healthcare specialist law firms. Tune in for a blow-by-blow description of the tactical decisions they made that led them to victory!

The first to file a “risk corridors” case in the nation for reneging on Obamacare’s promise, John’s guests detail how they worked together to drive their prosecution all the way up to the highest court in the land, and win!

Published: Mar 30 2022

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