Outrageous Or Overblown? HHS Announces Another Round Of ACA Navigator Funding Cuts

14 Julio, 2018, 02:56 | Author: Earnest Bishop
  • WASHINGTON DC- MARCH 22 U.S. President Donald Trump listens to Seema Verma administrator of the Centers for Medicare and Medicaid Service during a Women in Healthcare panel in the Roosevelt Room at the White House

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.

Over the weekend arrived some fresh political fury that the Trump Administration is trying to sabotage ObamaCare by suspending something called "risk adjustment" payments. The assault on pre-existing condition protections may make its way to the Supreme Court soon, and if Brett Kavanaugh is sitting on the bench, affordable health care for all will be at serious risk. The reality is sick people do rack up more health care costs. Having a risk adjustment program factors into these calculations.

Kavanaugh would not only be a critical vote on Texas, but also on dozens of health care cases pending in the lower courts which are likely to be appealed to the Supreme Court in upcoming terms.

Insurers were required to meet a June deadline to say in which in counties they'll sell insurance, as well as which kind of plans - so those are locked in, pending a state review.

Verma is right, just look at the awful recruitment results of these navigators over the past few years. In February, the U.S. District Court of New Mexico found the program to be based on flawed equations, and the agency has asked the court to reconsider its ruling, according to a recent statement. "As a result of this litigation, billions of dollars in risk adjustment payments and collections are now on hold". The Maryland Insurance Administration has a hearing scheduled for July 31.

To fully understand the administration's latest move, a little history is in order.

"This is how health care disparities are exacerbated - we will be put in the terrible position of pitting populations that need assistance against each other in order to prioritize how we can use the resources", she said. Republicans oppose the ACA on philosophical grounds that it forced citizens to purchase an expensive product they might not want or need, and on practical grounds that the ACA drove up costs because it required coverage for benefits many insurers didn't offer in past years unless customers paid extra. The announcement comes in the midst of the annual rate-filing period when insurers announce their estimated premium prices and plans for coverage to state regulators.

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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. In addition, both President Donald Trump and Senate Majority Leader Mitch McConnell have, in the past, supported the idea that insurers should not consider preexisting conditions when delivering coverage.

"We have to be very cautious".

"Investors should read headlines about the delay in risk adjustment payments cautiously", she said.

What is usually referred to as risk adjustment payments, aims to protect insurance companies from making hefty losses during their service delivery to the people.

The payments can be controversial, Dai said.

"We believe the impact will affect smaller insurers who have booked these payments on their balance sheet, but we believe the impact to the larger publicly traded health insurers is not as material", he said.

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