Trump Administration To Stop Paying Some Obamacare Bills

Trump admin expected to suspend some ObamaCare risk adjustment payments: report | TheHill

The Trump administration says it's freezing payments under an "ObamaCare" program that protects insurers with sicker patients from financial losses, a move expected to add to premium increases next year.

CMS provided a timeline, noting that after the February 28 decision by the New Mexico federal court, it filed a motion for reconsideration, and on June 21 the court held a hearing on it. CMS is waiting for the court's ruling, it said.

A federal court in MA upheld the same allocation formula in January.

"We urge the Trump administration to back off of this risky 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.

"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.

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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.

"Without a quick resolution to this matter, this action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices". "It will undermine Americans' access to affordable coverage, particularly those who need medical care the most". The program transfers funding from plans with lower-risk enrollees to higher-risk ones in an effort to even out the market and "encourage insurers to compete based on the value and efficiency of their plans rather than by attracting healthier enrollees", according to the Kaiser Family Foundation.

"I think insurers are going to be watching very closely what the administration says in court, and whether this is a sign of further steps to undermine the law, or a good faith effort to try to comply with the judge's order", he says. The government collects the money from health insurers with relatively healthy enrollees, who cost less to insure. These include eliminating the individual mandate penalty and broadening the availability of two alternatives to Affordable Care Act policies.

The administration has made several other moves in recent years to scale back or halt implementation of certain aspects of the ACA. Last year, the administration halted important subsidies for insurers.

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