Sunday, 22 July, 2018

Health care premiums could rise following Trump administration's

Trump administration freezes Obamacare payments, citing court decision Report: WH Suspends $10.4B in Obamacare Insurer Payments
Celia Hoffman | 11 July, 2018, 05:24

The Trump administration has halted billions of dollars in annual payments under the Affordable Care Act's risk adjustment program.

The Centers for Medicare and Medicaid Services said it had to put the payments on hold, after a USA district court judge ruled the government arrived at the formula that guides the payouts in a flawed way. The payments work this way: The government takes money from insurers with healthier, low-risk customers, and gives it to insurers with less-healthy, higher-risk customers.

In the meantime, some health insurers are potentially out billions of dollars.

The administration is taking legal steps to challenge the ruling in New Mexico, says Levitt.

CMS administrator Seema Verma said in a statement the administration was "disappointed" in the February ruling and that CMS has asked the court to reconsider and "hopes for a prompt resolution that allows CMS to prevent more adverse impacts on Americans". Small insurers often complain about risk adjustment payments because they end up paying their larger competitors, who tend to have the sickest patients.

Since Congress was unable to pass such a law, Trump and his aides have been taking a series of steps to weaken the law through administration maneuvers.

"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.

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"We are very discouraged by the new market disruption brought about by the decision to freeze risk adjustment payments", AHIP stated.

"Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare".

"This decision comes at a critical time when insurance providers are developing premiums for 2019 and states are reviewing rates".

The move should not have been unexpected given the administration's disdain for other provisions of the Affordable Care Act (ACA), leading to the elimination of other key taxpayer-funded subsidies and the outright eradication of the individual mandate through this past winter's tax cut legislation.

This is distinct from the debate over ObamaCare's cost-sharing payments, which the Trump Administration cut off a year ago after a federal judge barred the subsidies that Congress had not appropriated.

But supporters of the ACA criticized the CMS announcement as the latest move by the Trump administration to undermine Obamacare. CMS says the New Mexico court's ruling bars "CMS from collecting or making payments under the current methodology, which uses the statewide average premium".

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

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