Trump administration cuts grants to help people get Obamacare

Credit Kaiser Family Foundation

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. Administration officials tout these plans as more affordable, but they're cheaper because they don't have to meet the ACA's requirements for decent health plans, like including maternity care and prescription drug coverage, and charging the same rate for people with preexisting conditions. Typically, agencies publish proposed rules to allow time for public comment before they go into effect.

The Trump administration says the freezing of these payments is based on a ruling by a federal judge in Albuquerque, New Mexico, who ruled that part of risk adjustment provision's implementation was flawed and hadn't been adequately justified by federal regulators. More will lose their insurance this year with this latest attack on the ACA. 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.

"The federal government's decision to suspend payment transfers under the ACA's risk adjustment program could have a significant impact on premiums and place an additional burden on people in the community who can least afford it", CareFirst's president and CEO, Brian Pieninck, said in a statement.

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Insurers decried the move, and have been pressing the administration to resolve the issue and resume the payments, arguing that premiums will rise for ObamaCare enrollees if funding is cut off.

The Trump White House has been busy separating migrant families and plotting the demise of Roe v. Wade in recent weeks, but don't worry: they haven't forgotten about their quest to make it harder for Americans to obtain adequate health insurance.

The administration argued in its announcement that its hands were tied by conflicting court rulings in New Mexico and MA. "We're now in the midst of the 2019 rate-filing process and it's not clear how the risk-adjustment program will be operating", said Cori Uccello, senior health fellow at the American Academy of Actuaries. Rate filings by CT health insurers for 2019 are due next week.

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The cost of any increase in premiums that results from the risk adjustment payments may come from taxpayer dollars. Verma said the administration is defending the risk adjustment regulation, even though it was written under the Obama administration. If that doesn't happen, some insurers may need to boost their premiums for 2019, she said. States also have to prove to CMS that navigators met enrollment goals and provided information to consumers about all possible health plan options.

The most radical plan drafted by congressional Republicans last year-known as the Graham-Cassidy bill after two of its authors, Lindsey Graham (South Carolina) and Bill Cassidy (Louisiana)-would basically eliminate the ACA's private insurance marketplaces as well as Medicaid expansion, replacing them with lower-funded state block grants with few strings attached.

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