Thursday, 20 September, 2018

Trump Administration Slashes ACA Navigator Outreach Program -- And For Good Reasons

In another act of sabotage Trump slashes Obamacare outreach funding to the bone Maryland insurers say Trump Administration to cut health payments destabilizes market
Celia Hoffman | 13 July, 2018, 22:58

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The federal Centers for Medicare and Medicaid Services will temporarily freeze payments for the so-called "risk-adjustment" program that takes money from insurers and redistributes it to companies with more expensive patients.

Risk adjustment is one of three methods built into the 2010 health-care law to help insulate insurance companies from the ACA requirement that they accept all customers for the first time - healthy and sick - without charging more to those who need substantial care. The agencies in a statement said that they were seeking legal redress and understanding and will be informing all the involved participants of any bring up-to-date information regarding the current collections or future payments at the right time.

Since Republican campaigns to kill Obamacare failed in Congress previous year, the Trump administration has been taking every opportunity to sabotage the Affordable Care Act.

The president last fall issued an executive order to try to make it easier for individuals and small businesses to buy health plans that cost less than ACA coverage because they cover fewer services and bypass rules meant to protect people from previous practices in which insurers charged higher prices to women, older people and those with pre-existing medical conditions.

CMS Administrator Seema Verma says the navigators just aren't cost effective.

More news: $4.69 Billion Verdict Pounds Johnson & Johnson in 22-Plaintiff, Talc-Cancer Trial

A federal judge in D.C.

Navigators are usually members of nonprofit and community organizations. On Saturday the administration announced it was suspending a risk adjustment program. About 20 million Americans have received health insurance coverage through the program. Another federal judge upheld the risk adjustment formula in a separate case filed in MA. The administration could just as easily have listened to a judge in MA who ruled the opposite way or awaited the results of an appeal. The fund would be separate from the federal risk adjustment payments and could allow the insurers to reduce their requested rate increases by as much as 30 percent.

Health insurers warn that a move by the Trump administration on Saturday to temporarily suspend a program that was set to pay out $10.4 billion to insurers for covering high-risk individuals a year ago could drive up premium costs and create marketplace uncertainty. Rate filings by CT health insurers for 2019 are due next week.

Jeffrey Loo, an analyst at CFRA Research, said health insurers are preparing 2019 rates "and this suspension adds financial uncertainty". "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".

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.

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.

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