Trump's Latest Affordable Care Act Move Adds to Insurers' Uncertainty

Trump administration says it’s freezing payments under an ‘Obamacare’ program that protects insurers with

Trump administration says it’s freezing payments under an ‘Obamacare’ program that protects insurers with

"Suspending the Risk Adjustment Program is the Trump administration's latest attempt to do administratively what they couldn't do legislatively: dismantle the Affordable Care Act", he said.

The Centers for Medicare and Medicaid Services, which administers programs under the Affordable Care Act, indicated that about $10.4 billion in risk adjustment payments are impacted, according to reports. While the administration says it is required to stop payments because of the court decision, insurers say the move could result in higher premiums for millions of individuals and small businesses.

"As a result of this litigation, billions of dollars in risk adjustment payments and collections are now on hold", CMS Administrator Seema Verma said in the agency's statement. The permanent program was meant to reduce the incentive for health insurers to cherry-pick healthy members.

CMS plans to appeal the court's ruling, as the U.S. District Court for the District of MA ruled to uphold the payments. Insurers say the sudden halting of those payments creates uncertainty at a critical time, as they are now developing their premiums for 2019.

Insurance companies responded quickly on Saturday with their disapproval. America's Health Insurance Plans said it was "very discouraged" by the CMS' decision, which comes as insurers determine their premiums for 2019 and states review those proposals.

Dr. Dave Weldon, president of the Alliance of Health Care Sharing Ministries, discusses why health care sharing ministries could be a good alternative for people who can't find affordable health care. He says halting the risk adjustment program will disrupt the individual markets, and might even cause insurers not to participate next year. No taxpayer subsidies are involved. "This is one of several steps the Trump administration has taken to undermine the ACA".

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But to Rodney Whitlock, Vice President of Health Policy at ML Strategies and former Republican congressional aide, it's not perplexing at all.

FILE PHOTO: A man fills out an information card during an Affordable Care Act outreach event hosted by Planned Parenthood for the Latino community in Los Angeles, California September 28, 2013.

Democrats, meanwhile, are seizing on the unexpected action by characterizing it as another example of the administration sabotaging ObamaCare, a key Democratic message heading into the November midterm elections. However, under Obamacare, insurance companies can not charge higher premiums, or even deny coverage, to clients with pre-existing conditions.

More broadly, the move contributes to a string of actions from the Trump administration, including the cancellation of other ObamaCare payments past year, that have added to insurers' uncertainty and frustration. The administration has to have a legal justification for their actions.

It could also encourage more insurers to bow out of Obamacare.

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