Joshua Gillin
By Joshua Gillin February 25, 2016

Marco Rubio: We 'wiped out' Obamacare 'bailout fund' for insurance companies

Florida Sen. Marco Rubio took an outsize swing at a provision of Obamacare as GOP presidential candidates hammered their favorite target during the CNN debate in Houston.  

"When they passed Obamacare, they put a bailout fund in Obamacare," Rubio said while addressing frontrunner Donald Trump on Feb. 25, 2016. "All these lobbyists you keep talking about, they put a bailout fund in the law that would allow public money to be used, taxpayer money, to bail out companies when they lost money. We led the effort and wiped out that bailout fund."

Did Obamacare contain a bailout for insurance companies, and did Rubio and congressional Republicans get rid of it? In short, they postponed a provision of the law, but it wasn’t a bailout.

Risky business

What Rubio calls a bailout is actually a part of the Affordable Care Act known as "risk corridors."

When the health care law started requiring insurance companies to sell policies to everyone (even sick people with pre-existing conditions), those companies were caught in a tough spot. They didn’t know how much to charge in premiums to cover expenses for all those new policies.

So the law set up a three-year period, from 2014 to 2016, during which the government would spread the risk for insurers in the new law’s marketplaces while they adjusted premiums. This program is known as risk corridors.

If a company is good at setting its rates and make more than a certain amount, they pay Washington some of their extra money. These are called user fees. If a company is not so good at setting rates and loses money, the government would cover some of their losses.

That’s the bailout to which Rubio is referring. He started calling it a "bailout" for unsuccessful insurance companies in 2013, the same year he introduced an ill-fated bill in the Senate to repeal the program.

But let’s be clear: Several experts told us risk corridors aren’t a bailout. A bailout is usually a program that saves a company after the fact. Risk corridors are a mechanism that was put in place to deal with a problem that everyone assumes could occur.

And they aren’t new, either. The risk corridors program was modeled after a successful plan that was part of George W. Bush’s Medicare Part D prescription drug coverage, albeit slightly different than the Obamacare version. No one referred to that as a bailout.

Finding money for payments

Now, part of the problem is that the the health care law didn’t say where it would get the money for any risk corridor payments. Remember those user fees from successful insurers? The Centers for Medicare and Medicaid Services, or CMS, later decided they would use that money to make any payments owed to insurers that weren’t so successful.

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In 2013, CMS said insurers who said they needed money would get it, "regardless of the balance of payments and receipts" in the program. Rubio took this to mean that if there wasn’t enough money from user fees to cover the payments, the White House would ask Congress for money -- that is, tax revenue.

CMS said in April 2014 it wouldn’t ask Congress for an appropriation, but instead would make up the difference in later years if the marketplace didn’t bring in enough user fees. Rubio went to work, urging then-Speaker of the House John Boehner in October 2014 to block potential tax money appropriations for risk corridor payments.

That’s what Congress did. When lawmakers passed a spending bill in December 2014, it included special language called a "rider" that said the CMS’ parent agency, the U.S. Department of Health and Human Services, could not use any extra money in its budget to pay risk corridor expenses. That effectively locked CMS into its stated plan of using user fees. (The same rider was included in the 2015 spending bill.)

Some legislators have credited Rubio with inspiring this language, although there have been questions about how much credit he can take. Rubio reintroduced his bill to repeal risk corridors.

By October 2015, it became apparent the risk corridors program didn’t work so well in the first year. CMS announced the program took in $362 million in user fees for 2014, while less successful insurers asked for a total of $2.87 billion, leaving a $2.5 billion shortfall CMS can’t pay.

CMS said it would pay out 12.6 percent of claims from 2014, then wait to see next year’s results. Some insurers left the marketplaces or even collapsed altogether, leading Rubio to crow his actions have been "a big part of ending Obamacare for good." (We likely won't know what the program took in for 2015 until fall 2016, and 2016’s totals until 2017.)

Whether it will really kill Obamacare is up for debate. Some legal scholars have said all the rider did was highlight a problem the law already had and prevent a workaround. Two years ago, the Congressional Budget Office said the risk corridors will likely eventually break even by 2016.

If the program doesn’t, CMS will have to find the money somehow or ask Congress to make an appropriation to pay insurers. Otherwise, insurers could sue to get those payments. An Oregon insurance company that is no longer offering marketplace plans did just that on Feb. 24, suing the government for $5 billion over missed risk corridors payments.

Our ruling

Rubio said, "When they passed Obamacare, they put a bailout fund in Obamacare. … We led the effort and wiped out that bailout fund."

The "bailout fund" is actually a provision in the Affordable Care Act called risk corridors, designed to temporarily aid insurers as they adjust premiums. Rubio helped persuade Congress to prevent Health and Human Services from being able to cover expenses its own budget.

But experts have said Rubio is wrong to call the program a bailout, and that the program is supposed to pay for itself through fees from insurers.

Furthermore, the program hasn’t been "wiped out." At best, Rubio and Congress have temporarily limited one potential way CMS could have covered insurance companies' losses. We’ll have to see what happens when the program expires after 2016 -- then any outstanding bills will be due, one way or another.

We rate Rubio’s statement Mostly False.

https://www.sharethefacts.co/share/33a7e991-0d94-4526-a5a9-3a3f7a9a0fec

Our Sources

Marco Rubio, CNN GOP debate, Feb. 25, 2016

Centers for Medicare and Medicaid Services, letter to insurance commissioners, Nov. 14, 2013

Wall Street Journal, "Marco Rubio: No Bailouts for ObamaCare," Nov. 18, 2013

Sen. Marco Rubio, "Rubio Introduces Bill Preventing Taxpayer-Funded Bailouts Of Insurance Companies Under ObamaCare," Nov. 19, 2013

National Review, "The Obamacare Risk Corridors," Nov. 20, 2013

PunditFact, "Krauthammer: Obamacare has hidden insurance company bailout,"  Jan. 13, 2014

Congressional Budget Office, "Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act," April 2014

Centers for Medicare and Medicaid Services, "Risk Corridors and Budget Neutrality," April 11, 2014

PunditFact, "Carville: Insurance risk corridors aren't going broke like Republicans predicted," April 13, 2014

The Incidental Economist, "Does the risk corridor program have a fatal technical flaw?," May 1, 2014

HealthAffairs.org, "Risk Corridors And Budget Neutrality," May 14, 2014

Rep. Leonard Lance, "Effort to Stop Insurance Company Bailouts Gains Momentum," July 28, 2014

U.S. House of Representatives Committee on Oversight and Government Reform, "ObamaCare’s Taxpayer Bailout of Health Insurers and the White House’s Involvement to Increase Bailout Size," July 28, 2014

Sen. Marco Rubio, "Rubio, Colleagues To Boehner: We Must Protect Congressional Authority, Prohibit ObamaCare Bailout," Oct 8, 2014

Sen. Marco Rubio, letter to John Boehner, Oct. 8, 2014

New York Times, "Senate Passes $1.1 Trillion Spending Bill, Joining House," Dec. 13, 2014

Sen. Marco Rubio, letter to Paul Ryan, Mitch McConnell, etc., Nov. 24, 2015

Sen. Marco Rubio, "Rubio Introduces Bill Preventing Taxpayer-Funded Bailouts Of Insurance Companies Under ObamaCare," Jan. 8, 2015

Sen. Bill Cassidy, "Cassidy, Rubio: No Obamacare Insurance Company Bailout," Feb. 4, 2015

The Hill, "GOP bill hits ObamaCare risk corridors," Feb. 5, 2015

HealthAffairs.org, "Risk Corridors. An amendment to the 2015 federal budget continuing appropriation raises a question: Will insurers receive their full 2014 risk corridor payments?," Feb. 19, 2015

Medicare Payment Advisory Commission, "Report to the Congress: Medicare and the Health Care Delivery System: Sharing risk in Medicare Part D," June 2015

Centers for Medicare and Medicaid Services, "The Three Rs: An Overview," Oct. 1, 2015

Centers for Medicare and Medicaid Services, "Risk Corridors Payment Proration Rate for 2014," Oct. 1, 2015

Sen. Marco Rubio, "Rubio Saves Taxpayers Over $2.5 Billion In Obamacare Bailout Funds, Calls For Taking Option Off The Table For Good," Oct. 2, 2015

Centers for Medicare and Medicaid Services, "Risk Corridors Payments for the 2014 Benefit Year," Nov. 19, 2015

Washington Examiner, "Rubio to GOP congressional leaders: Let's stop Obamacare bailouts," Nov. 24, 2015

The Hill, "Rubio budget win is dealing heavy blow to ObamaCare," Nov. 24, 2015

Bloomberg Politics, "Marco Rubio Didn't 'Kill' Obamacare, But Here's How He Undermined It," Nov. 25, 2015

The Incidental Economist, "Did Marco Rubio Kill Obamacare?," Dec. 1, 2015

Fox News, "’Saved us money’: Rubio wins conservative cred for ObamaCare change," Dec. 1, 2015

PolitiFact, "Rubio says he prevented a $2.5 billion taxpayer bailout for Obamacare," Dec. 7, 2015

The Hill, "Spending bill includes Rubio ban on ObamaCare 'bailout’," Dec. 16, 2015

Portland Business Journal, "Health Republic files $5B suit against U.S., cites 'cascading, fatal' measures," Feb. 24, 2016

MarcoRubio.com, "Marco Killed the Obamacare Bailout Once, Now He Wants It Dead For Good," accessed Feb. 25, 2016

Congress.gov, "S.1726 — Obamacare Taxpayer Bailout Prevention Act," accessed Feb. 25, 2016

U.S. Government Publishing Office, "H. R. 83—362, Sec. 227," accessed Feb. 25, 2016

Congress.gov, "S.123 — Obamacare Taxpayer Bailout Prevention Act," accessed Feb. 25, 2016

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