Moda Health

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Moda Health
FormerlyODS Health
Company typePrivate, For-profit
IndustryHealth insurance
Founded1955; 69 years ago (1955)
HeadquartersPortland, Oregon
Area served
Alaska, Oregon, Texas, Washington
Websitewww.modahealth.com

Moda Health (formerly ODS Health) is a health insurance company based in Portland, Oregon. The company provides medical and dental insurance in Oregon, Alaska and Texas (and in Washington state before 2016). The Moda Center, a sports arena that is home to the Portland Trail Blazers, and Moda Tower, the tenth-tallest building in Portland, are both named after the company. Moda Health is a member of Delta Dental.

History

Originally started as part of the Oregon Dental Society (now the

Seattle Reign. As of 2013, the company had nearly 1,400 employees and $1.7 billion in annual revenues.[5]

ACA's Risk corridor program

The

PPACA section 1342,[6]
: 1  was a temporary risk management device, modeled on similar successful risk corridors in Medicare Part D,[7] to encourage reluctant insurers into the "new and untested" ACA insurance market during the first three years that ACA was implemented (2014-2016).[8] While the program did succeed in attracting insurers, it did not pay for itself and suffered billions of dollars of losses and funds were to be paid from "general government revenues". Congressional Republicans "railed against" the program as a 'bailout' for insurers.[8] and in 2014, then-Rep. Jack Kingston (R-Ga.), on the Appropriations Committee that funded the HHS "[slipped] in a sentence" — Section 227 — in the "massive" spending bill that said that no funds in the discretionary spending bill "could be used for risk-corridor payments." This effectively "blocked the administration from obtaining the necessary funds from other programs."[9] Moda, and a number of other insurers, suffered financially.[10]

As a result, in January 2016, regulators in Oregon and Alaska temporarily suspended the ability of Moda Health to sell insurance after large financial losses left it with a lack of capital.[11][12] The restrictions were lifted in February 2016 after the parent company agreed to raise additional funds.[13][14]

Moda Health Plan, Inc. v. The United States

Moda Health took the case to court and won a "$214-million judgment against the federal government". On February 10, 2017, Judge Thomas C. Wheeler stated, "the Government "made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise. After all, 'to say to [Moda], 'The joke is on you. You shouldn't have trusted us,' is hardly worthy of our great government."[15]

On June 14, 2018, the U.S. Court of Appeals for the Federal Circuit Court overturned the lower court ruling, reversing the $214 million judgment.[16] The Supreme Court later ruled in favor of Moda Health.[17]

References

  1. Portland Business Journal
    . March 9, 1997. Retrieved 2 April 2014.
  2. ^ Goldfield, Robert; Kathy Brock (September 22, 1996). "ODS Health to anchor Wright Runstad tower". Portland Business Journal. Retrieved 2 April 2014.
  3. ^ "Les Schwab and Stoel Rives Retirement trusts buy ODS Plaza". Portland Business Journal. August 10, 1999. Retrieved 2 April 2014.
  4. ^ Stevens, Suzanne (May 6, 2013). "ODS changes its name, shifts focus". Portland Business Journal. Retrieved 2 April 2014.
  5. ^ Meyers, Sean (July 26, 2013). "Health care changes put Moda into growth mode". Portland Business Journal. Retrieved 2 April 2014.
  6. ^ Legislative Attorneys, American Law Division (January 5, 2016), Lawsuits to Recover Payments under the Risk Corridors Program of the Affordable Care Act (PDF), Congressional Research Service, p. 6, retrieved February 11, 2017
  7. ^ "Yes Marco Rubio led the effort to end Obamacares health insurance slush fund", Forbes, December 15, 2015, retrieved February 10, 2017
  8. ^ a b Michael Hiltzik (February 10, 2017), "With billions at stake, a federal judge just nullified the GOP's most cynical attack on Obamacare", LA Times, retrieved February 10, 2017
  9. ^ Glenn Kessler (December 23, 2015), Rubio's inaccurate claim that he 'inserted' a provision restricting Obamacare 'bailout' funds, retrieved February 11, 2017
  10. PMID 27959725
  11. ^ Hayes, Elizabeth (January 28, 2016). "State forces Moda Health to exit individual insurance market, requires it to raise capital". Portland Business Journal. Retrieved February 15, 2016.
  12. ^ Manning, Jeff (January 28, 2016). "State forces tight controls on Moda, citing insurer's weakened financial condition". The Oregonian. Retrieved February 15, 2016.
  13. ^ Sickinger, Ted (February 8, 2016). "Moda can continue to operate under agreement with regulators to inject new cash". The Oregonian. Retrieved February 15, 2016.
  14. ^ Bohrer, Becky (February 10, 2016). "Moda Health suspension lifted; company must raise $179M". Alaska Journal of Commerce. Retrieved February 15, 2016.
  15. ^ Moda Health Plan, Inc. v. The United States, US Courts, February 10, 2017, p. 40, retrieved February 10, 2017
  16. ^ In a reversal, Moda loses $214M appeal against the federal government, KGW, June 14, 2018, retrieved June 20, 2018
  17. ^ Manning, Jeff (2020-04-28). "Moda wins long-shot $250 million lawsuit against federal government". oregonlive. Retrieved 2023-06-09.

External links

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