Health insurers warned 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 last year could drive up premium costs and create marketplace uncertainty.
The Affordable Care Act’s (ACA) “risk adjustment” program is intended to incentivize health insurers to cover individuals with pre-existing and chronic conditions by collecting money from insurers with relatively healthy enrollees to offset the costs of other insurers with sicker ones.
President Donald Trump’s administration has used its regulatory powers to undermine the ACA on multiple fronts after the Republican-controlled Congress last year failed to repeal and replace the law propelled by Democratic President Barack Obama. About 20 million Americans have received health insurance coverage through the program known as Obamacare.
America’s Health Insurance Plans (AHIP), a trade group representing insurers offering plans via employers, through government programs and in the individual marketplace, said the CMS suspension would create a “new market disruption” at a “critical time” when insurers are setting premiums for 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. And costs for taxpayers will rise as the federal government spends more on premium subsidies,” AHIP said in a statement.
It could also encourage more insurers to bow out of Obamacare.
“This is occurring right at the time of year that people (insurers) are making decisions about whether to participate in the exchanges and what premiums to charge if they do,” said Eric Hillenbrand, a managing director at consultancy AlixPartners. “This will affect their thinking on both of those decisions.”
The Centers for Medicare and Medicaid Services (CMS), which administers ACA programs, said on Saturday that months-old conflicting court rulings related to the risk adjustment formula prevent them from making payments.
CMS was referring to a February ruling from a federal court in New Mexico that invalidated the risk adjustment formula, and a January ruling from a federal court in Massachusetts that upheld it.
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.”
But supporters of the ACA criticized the CMS announcement as the latest move by the Trump administration to undermine Obamacare.
“We urge the Trump administration to back off of this dangerous and destabilizing plan, and instead begin working on bipartisan solutions to make coverage more affordable,” said Brad Woodhouse, the executive director of Protect Our Care, a progressive group that supports Obamacare.
The administration has made several other moves in recent years to scale back or halt implementation of certain aspects of the ACA.
Late last year, it said it would halt so-called cost-sharing payments, which offset some out-of-pocket healthcare costs for low-income patients.
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. “It moves us back to some extent to the status quo where people with pre-existing conditions found it very difficult to get insurance.”
Additional reporting by Yasmeen Abutaleb in Washington; Editing by Mary Milliken and James Dalgleish
Iran says seized British-flagged tanker ‘free’ to leave
Iran said on Monday that a British-flagged oil tanker is "free" to leave more than two months after it was seized in the Gulf.
"The legal process has finished and based on that the conditions for letting the oil tanker go free have been fulfilled and the oil tanker can move," government spokesman Ali Rabiei told a news conference.
He did not specify when the Swedish-owned vessel would be allowed to set sail.
The Islamic Revolutionary Guard Corps surrounded the Stena Impero with attack boats before rappelling onto the deck of the tanker in the Strait of Hormuz on July 19.
MSNBC’s Morning Joe fact-checks Trump’s ‘slimy’ lies about Biden: ‘He’s rigging the election!’
MSNBC's Joe Scarborough threw cold water on President Donald Trump's accusations against Joe Biden, as the Ukraine scandal continues to widen.
The "Morning Joe" host ripped the president for pressuring Ukraine's president to dig up dirt on Biden and then leaning on states to cancel Republican primaries to snuff out three challengers' campaigns.
"You talk about an inside game, rigging the process, and we talked about how Donald Trump is rigging the process on the Republican side to make sure that as many states as possible cancel democratic elections for the primary," Scarborough said. "I mean, he's learning from Vladimir Putin the way you get 100 percent of the vote is you just cancel the elections, and that's what Donald Trump is getting Republican operatives to do across the country."
Trump condemned for moving to ‘roll back the clock’ as letter exposes his attempt to form anti-abortion UN coalition
"It's not just abortion that they care about, they care about women's ability to exercise autonomy over their bodies and about denying them critical access to the services they need."
Global women's rights advocates raised alarm Monday after a leaked letter showed the Trump administration is pressuring U.N. member nations to join an international anti-abortion coalition.