Professor Robert Field joined a panel of experts discussing the uncertain future of the Affordable Care Act on Knowledge at Wharton Radio on March 29.

Insurers have filed dozens of lawsuits against the federal government seeking some $12.3 billion in dues they expected to receive under a “risk corridor” program created under the ACA to incentive companies to offer coverage in vulnerable markets. With the matter in legal limbo, premiums have risen.

“The ACA provided for these payments and by the time they came due, it was a Republican Congress, and they refused to appropriate the money,” Field said. “Obama was able to switch around some funds and pay it. Trump said he would not.”

What’s unclear, Field said is whether the administration can pay the money without an explicit appropriation from Congress.

“If insurers feel that the government won’t make good on promises that were in the ACA, what will that do to their participation in the exchanges in the future?” Field asked. “Are they going to get spooked, or are they going to decide that this is one more straw on the camel that might break its back and decide that these exchanges aren’t worth it?”

The impasse over payments under the risk corridor program has put the future of the ACA in doubt, Field said.

“It’s death by a thousand cuts,” he added.