WASHINGTON-The Trump administration's move to suspend billions of dollars in payments that insurers expect injects new uncertainty into the Affordable Care Act's insurance markets right as the companies are deciding next year's rates.
The court sent the rules back to the Centers for Medicare and Medicaid Services to rework the formula. But another district court in MA upheld the formula. "As a result of this litigation, billions of dollars in risk adjustment payments and collections are now on hold".
CMS said that the amount frozen for the 2017 benefit year is $10.4 billion, which is drawn from insurers to go to other insurers.
"We are very discouraged by the new market disruption brought about by the decision to freeze risk adjustment payments", the group said in a statement Saturday.
The trade organization representing health insurers says the decision to halt the payments will have major impacts on consumers - especially those who get their coverage through a small business or buy it on their own. "And costs for taxpayers will rise as the federal government spends more on premium subsidies", AHIP said in a statement.
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Trump administrators suspended the payments over a February ruling by a federal district court in New Mexico, according to the reports. "It will undermine Americans' access to affordable coverage, particularly for those who need medical care the most".
The pro-ACA group Protect Our Care issued a statement from its executive director, Brad Woodhouse, Saturday after the administration announced its decision regarding risk penalty payments, characterizing the move as further chipping away at the Affordable Care Act. The goal is for insurers to compete based on the value of their plans, not just attempting to attract healthier customers.
Trump and his team have continued to argue that the individual mandate is unconstitutional and has promised to refuse to defend any parts of Obamacare in court. To do that, the government collects money from health insurers with enrollees who were healthier and as a result "cost less to insure".
Trump continues to attack Obamacare even as almost a dozen insurers have started to warm to the program with at least a dozen states seeing an increase in the number of insurers participating in the healthcare exchange. Insurers were entering or returning to at least a dozen states for 2019 enrollment, while others were expanding their presence in the states in which they operate.
But supporters of the ACA criticized the CMS announcement as the latest move by the Trump administration to undermine Obamacare.