Published: Wed, July 11, 2018
Medical | By Johnnie Horton

Trump administration halts billions in Obamacare payments to health insurers

Trump administration halts billions in Obamacare payments to health insurers

President Donald Trump's administration is freezing billions of dollars in payments to health insurers under the Affordable Care Act's risk adjustment program.

Reuters' characterization of the move is that "President Donald Trump's administration has used its regulatory powers to undermine Obamacare after the Republican-controlled Congress a year ago failed to repeal and replace the law".

America's Health Insurance Plans (AHIP), the trade organization representing health insurers, decried the suspension of the payments.

New Mexico Health Connections and Minuteman Health of MA, two small nonprofit insurers, filed lawsuits in 2016, contending that the Obama administration created an inaccurate formula that unfairly rewarded large insurers.

"An effective risk adjustment program is crucial to the sound operation of a health insurance marketplace in which individuals, families and small businesses with health needs have access to more affordable, high-quality coverage", said Bill Wehrle, Kaiser Permanente vice president of health insurance exchanges, in a statement.

Navigators applying for funding will also be encouraged to show how they will educate people about the newly expanded alternatives to Obamacare, such as association health plans and short-term plans. The news comes in the wake of a ruling by a U.S. District Court judge in New Mexico which says the Center for Medicare and Medicaid Services (CMS) payment program is legally flawed.

The New Mexico ruling found fault with the formula used by the government to calculate the payments, saying it was "arbitrary and capricious". "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.

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The Trump administration has halted billions of dollars of Obamacare payments to insurers due to a court ruling.

Officials with CareFirst BlueCross BlueShield, one of two Maryland insurers that sell Affordable Care Act plans, said they need the payments to keep that part of their business afloat.

It has also scaled back the advertising budget for Obamacare healthcare plans during the open-enrollment period by about 90 percent.

"What you are effectively doing is dismantling pieces of [the ACA] without replacing them", Hillenbrand said. Almost half of us living in North Dakota have a pre-existing condition and could be found "left out in the cold" without insurance.

The risk-adjusted premium pool takes money from healthier patients paying for health care and redistributes it to the less healthy, more needy patients to pay for higher premiums. "Following through with this latest act of sabotage could raise rates for all consumers even more".

The bottom line is that the Trump administration is making good on its promise to rid Americans of Obamacare, with or without the help of the legislature.

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