Kreidler: Trump action signals continuing moves to harm individual health insurance

WASHINGTON DC- MARCH 22 U.S. President Donald Trump listens to Seema Verma administrator of the Centers for Medicare and Medicaid Service during a Women in Healthcare panel in the Roosevelt Room at the White House

Since efforts in Congress to repeal Obama's signature health care law failed, the Trump administration to pursue administrative changes to chip away at the 2010 law. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

The Trump administration announced Tuesday it is making further cuts to the "navigator" program that provides in-person assistance to people seeking coverage on Obamacare's web-based marketplace.

Three programs in The Affordable Care Act endeavored at minimizing the risk to the insurers as they explored the risky markets.

CMS said in a statement that the funds were being cut because people are more familiar with the exchange program, and that the programs enrolled less than 1% of participants past year.

The issue is expected to be resolved by the end of the year and risk adjustment transfers will be completed "on time or with only minimal delay", she said. The Trump administration also is seeking to expand the use of short-term health insurance plans that are often less expensive but don't have the same consumer protections as exchange plans. "And costs for taxpayers will rise as the federal government spends more on premium subsidies", AHIP said in a statement. The judge tossed out the formula used to calculate payments, finding that it was flawed.

The cut will impact navigators, the nonprofit organizations which the federal government pays to assist with registration in the countries which use HealthCare.gov due to their online market for individuals attempting to have protection through the Affordable Care Act.


CMS is freezing $10.4 billion in Affordable Care Act risk-adjusted payments, created to stabilize the insurance market by redistributing money to insurers with higher-cost members. The announcement comes in the midst of the annual rate-filing period when insurers announce their estimated premium prices and plans for coverage to state regulators.

On Saturday, the administration said it would suspend a program that was set to pay out $10.4 billion to insurers for covering high-risk individuals under Obamacare past year, saying that a recent federal court ruling prevents the money from being disbursed.

But in January, in a separate case, a federal district judge in MA upheld the government formula used to calculate the payments. With suspension of the risk adjustment payments, insurers must now contend with another disruption to the market by the time they finalize rates early this fall. "It is important to keep in mind that the original risk adjustment payments are budget-neutral such that for some insurers to win, other insurers have to lose".

Every action the Trump administration has taken on Obamacare suggests that's their goal. "There is a need to analyze insurers case-by-case and account for their competitive landscapes", said Tinglong Dai, an associate professor of operations management and business analytics at the Johns Hopkins University Carey Business School.

Whatever happens with the risk adjustment payments, it looks as if many exchange consumers will be left to figure out their options for 2019 on their own.

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