The Health Insurers Squawk

11 Julio, 2018, 05:22 | Author: Earnest Bishop
  • Trump administration freezes Obamacare payments, citing court decision

"As a result of this litigation, billions of dollars in risk adjustment payments and collections are now on hold", she said. The federal Centers for Medicare & Medicaid Services - known by the abbreviation CMS - will temporarily stop so-called "risk-adjustment payments" used to steady Obamacare health insurance premiums.

A federal court in MA upheld the same allocation formula in January.

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The ripple comes at a pivotal time for the Affordable Care Act's marketplace. "CMS has asked the court to reconsider its ruling, and hopes for a prompt resolution that allows CMS to prevent more adverse impacts on Americans who receive their insurance in the individual and small group markets", CMS Administrator Seema Verma said in a July 7 statement.

CMS provided a timeline, noting that after the February 28 decision by the New Mexico federal court, it filed a motion for reconsideration, and on June 21 the court held a hearing on it. CMS is waiting for the court's ruling, it said. He says halting the risk adjustment program will disrupt the individual markets, and might even cause insurers not to participate next year. "It will create more market uncertainty and increase premiums for many health plans - putting a heavier burden on small businesses and consumers, and reducing coverage options", AHIP said.

President Donald Trump's administration has used its regulatory powers to undermine the ACA on multiple fronts after the Republican-controlled Congress a year ago failed to repeal and replace the law propelled by Democratic President Barack Obama. Since when did the claims of insurers become a reliable guide to American health care?

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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. Earlier this year, the Trump administration proposed to expand short-term junk plans, which are not required to cover people with pre-existing conditions.

These moves are prompting some insurers to request premium hikes for 2019 in the double digits.

A professor who follows Obamacare said it is unclear if the payments' suspension will result in higher premiums. "It is important to keep in mind that the original risk adjustment payments are budget-neutral such that for some insurers to win, other insurers have to lose".

The payments can be controversial, Dai said.

The Trump administration on Saturday halted billions of dollars in payments to health insurers under the Obamacare healthcare law, saying that a recent federal court ruling prevents the money from being disbursed. In Maryland, Kaiser usually ends up paying CareFirst.

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