Trump Administration Halts Payments Under Obamacare Program

  • Trump Administration Halts Payments Under Obamacare Program

Trump Administration Halts Payments Under Obamacare Program

WASHINGTON-The Trump administration's move to suspend billions of dollars in payments that insurers expect injects new uncertainty into the Affordable Care Act's insurance markets right as the companies are deciding next year's rates.

CMS was referring to a February ruling from a federal court in New Mexico that invalidated the risk adjustment formula, and a January ruling from a federal court in MA that upheld it.

CMS plans to appeal the court's ruling, as the U.S. District Court for the District of MA ruled to uphold the payments.

"We were disappointed by the court's recent ruling".

Officials said Saturday that the administration is acting because of conflicting rulings in lawsuits filed by some smaller insurers who question whether they're being fairly treated.

The move is expected to add to premium increases next year.

America's Health Insurance Plans, the trade organization representing health insurers, issued a statement saying it was "discouraged" by the decision to freeze risk adjustment payments.

The program is critical to markets under the Affordable Care Act because insurers with healthier consumers enrolled in plans reimburse insurers with sicker and more expensive enrollees. "The decision will have serious consequences for millions of consumers who get their coverage through small businesses or buy coverage on their own", the group said.

The Affordable Care Act's (ACA) "risk adjustment" program is meant to incentivize health insurers to cover individuals with pre-existing and chronic conditions by collecting money from insurers with relatively healthy enrollees to offset the costs of other insurers with sicker ones. "This action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices". CMS has made no public statements regarding policy changes for the risk-adjustment payments as of yet.

The suspension of the payments comes amid other efforts by the Trump administration to try to chip away at the landmark health care law. The move is just the newest in a series of attempts by Trump's administration to disrupt the insurance markets that the Affordable Care Act depends on to function. Last year, the administration halted important subsidies for insurers.

Trump continues to attack Obamacare even as almost a dozen insurers have started to warm to the program with at least a dozen states seeing an increase in the number of insurers participating in the healthcare exchange.