The Trump administration decided on Saturday, July 7, to suspend risk adjustment payments that were designed under the Affordable Care Act to provide stability to individual health insurance markets across the nation. Insurers are already saying the decision will force them to set their premiums even higher in 2019 to make up for this uncertainty, which is likely to price more people out of the market.
"Longer-term, I think that the administration's walk-back of risk-adjustment payments penalizes those payers that did, in fact, attempt to enroll participants without bias to health status, and unfortunately it also rewards those payers that for whatever reason chose to play it that much safer and do their best to recruit healthy individuals", Abrams says. Suspending the program could theoretically benefit those companies, which each owed other insurers about $1 billion under the program as of March 31, according to regulatory filings.
The navigators, Fann added, were needed more in 2013 and 2014 when the marketplaces were in their first years and millions of people who hadn't bought insurance before were considering the health law's new options. "And costs for taxpayers will rise as the federal government spends more on premium subsidies", AHIP said in a statement.
The decision to halt the payments casts further uncertainty over the ACA marketplaces at a time when insurers are finalizing their offerings for open enrollment in November. The excuse Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, is giving is that they believe the navigators don't sign up as many people as private entities like insurance brokers.
Many Trump followers often cheer cuts to Obamacare, not knowing that the Affordable Care Act and Obamacare are one in the same.
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"Given the continued attacks on healthcare, including federal rules allowing the resurgence of low-priced, junk health insurance plans, such as "association health plans" and "short-term plans", consumers looking for good, comprehensive coverage could be easily confused", Frederick Isasi, executive director of Families USA, a Democrat-leaning healthcare advocacy organization, told CNN. "It will undermine Americans' access to affordable coverage, particularly those who need medical care the most".
Signaling the administration's long-term objectives, Andrew Bremberg, who oversees domestic policy at the White House, told reporters past year, "The president still firmly believes that Congress must act to repeal and replace Obamacare, but before that can be done, this administration must act to provide relief". They also help consumers file appeals with insurers.
More than 20 million people have coverage through former President Barack Obama's law. Frank Pallone called the cuts more "sabotage" from the administration. The Kaiser Family Foundation estimates that 27 percent of people under the age of 65 have what could be considered a pre-existing condition. Immediately after Sen. John McCain (R-Ariz.) cast the deciding vote to block the dramatic repeal effort, Trump implored Republicans to let the law disintegrate.
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 nonpartisan Congressional Budget Office estimates that will raise premiums by about 10 percent. Such actions by the current administration are happening amid enrollment and setting of health plans for the next season. But premiums for people who buy individual coverage and are not eligible for ACA subsidies have continued rising by double digits.