Trump Administration To Stop Paying Some Obamacare Bills
15 July, 2018, 13:42
The Trump administration decided on Saturday, July 7, to suspend risk adjustment payments that were designed under the Affordable Care Act to provide stability to individual health insurance markets across the nation. The president's campaign has taken aim at the remaining fig leaves of reform in the health care legislation voted into law in 2010.
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The Associated Press contributed to this article.
Since then, the Labor Department has issued a rule to broaden the use of one such kind of insurance, called "association health plans".
In announcing a more than 70 percent funding cut from a year ago, the Centers for Medicare and Medicaid Services said in a notice that the marketplace navigator groups should be able to "stretch their funding further" with less demand for in-person assistance because the marketplace is more familiar to most Americans.
In its announcement, the CMS reprised arguments it made past year that navigators, which operate with the annual grants in the 34 states that rely on the ACA's federal insurance exchange, have been ineffective and are less important than they once were: "As the exchange has grown in visibility and become more familiar to Americans seeking health insurance, the need for federally funded navigators has diminished".
The Trump administration announced Tuesday it would could nationwide funding for navigators by 72 percent, from $36 million to $10 million. Even though some insurers might save money by not having to pay the adjustment fees, the uncertainty about the pool of those insured is likely to cause companies to charge more to cover their higher risk. Without this program, insurers might have taken on less risk in the market, especially in rural counties.
Insurance Commissioner Al Redmer Jr. said that as of now he doesn't expect the latest decision to interrupt the state's rate-setting process. Some companies that had expected hundreds of millions of dollars in risk-adjustment payments fear the funds may fall through, while others that had expected to owe hundreds of millions wonder if they may be off the hook. "However, only time will tell".
Three programs in The Affordable Care Act endeavored at minimizing the risk to the insurers as they explored the risky markets. Having a risk adjustment program factors into these calculations. The Trump administration is making it easier for Americans to sign up for these policies, which many experts say will weaken Obamacare by siphoning off younger and healthier enrollees.
Two Rochester-area insurance providers, Excellus BlueCross BlueShield and MVP Health Care, said it's too early to know how the suspension of the federal program will affect their customers. "CMS should use all legal avenues available to make the payments on schedule and should do so to protect consumers".
While imperfect, the risk adjustment program "has helped promote market stability over the past five years", Wehrle said.
Last August, federal health officials announced they were reducing the navigators' aid by 41 percent - from $62.5 million - and slashing a related budget for advertising and other outreach activities to foster ACA enrollment by 90 percent.
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