Outrage from Advocates as the U.S Freezes Funds for Obamacare Payments

The Trump administration finds another way to throw sand in Obamacare's gears at patients' expense

The Trump administration finds another way to throw sand in Obamacare's gears at patients' expense

"The Trump administration's suspension of risk adjustment payments is just the latest attempt to undermine health care for millions of consumers across the country, including about 270,000 people enrolled in Washington state's individual market". In January a federal court in MA ruled the formula wasn't arbitrary and capricious.

Last year's cut compelled navigators to put off employees, cancel occasions, and, sometimes, stop operations entirely. Many insurers that enroll large numbers of unhealthy people depend on the "risk adjustment" payments, which are meant to reduce the incentives for insurers to seek out healthy consumers and shun those with chronic illnesses and other pre-existing conditions.

The idea behind the program is to remove the financial incentive for insurers to "cherry pick" healthier customers.

"We're urging CMS to find a legal or regulatory path that allows immediate action to reinstate these payment transfers and ensure that coverage for millions of Americans is not disrupted", Kris Haltmeyer, vice president for legislative and regulatory policy at the Blue Cross Blue Shield Association, said in a statement.

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But CareFirst and Kaiser could ask to adjust their rates higher given the Trump administration's decision. These are people who are not going to go to an insurance agent or broker. It's reasonable for the government to slash the program. "Costs for taxpayers will rise as the federal government spends more on premium subsidies", said a statement from America's Health Insurance Plans, a health insurance industry trade group. In other words, the Trump Administration position in court is in favor of making the payments.

But despite President Donald Trump's disdain for "Obamacare", enrollment for subsidized private coverage has been fairly steady, with about 10 million people now signed up. These plans would bypass the law's protections that prevent companies from charging higher prices to women, older people and those with preexisting medical conditions. The administration is also pushing to broaden the definition of short-term insurance, which is also exempted from the ACA's rules.

For the past five years, when insurance has been available through ACA marketplaces for people who do not have access to affordable health benefits through a job, federal health officials have started every spring working with navigator groups on plans for the coming enrollment season. Many have started making a profit and some are expanding their involvement for 2019, a marked change from this time a year ago, when several carriers said they were going to pull out of the exchanges for 2018. This is another act of sabotage by the administration. This idea of pooling risk has had significant practical effects: encouraging insurers to participate in the insurance marketplaces the ACA created for Americans who can not get affordable health benefits through a job. That's because many ACA customers will qualify for federal government premium subsidies, which are still alive and well in Obamacare.

The program, which was created to be a permanent feature of the Affordable Care Act, transfers money from health plans with lower-risk consumers to plans with higher-risk consumers. Until now, the grants have been used only to help people choose and buy ACA health plans or to help steer people with low incomes toward Medicaid.

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