Trump Administration Halts Payments Under Obamacare Program

Trump Administration Freezes Payments to Affordable Care Act Insurers with Sicker PatientsMore

For example, it could have provided a more detailed explanation of the formula to the New Mexico court and kept the payments going. The CMS said it won't be making transfer payments for the 2017 benefit year totaling $10.4 billion.

Risk adjustment is an important part of the ACA.

Risk adjustment is a key aspect of market stabilization under the ACA, also known as Obamacare.

"It has caused insurer collapses and market exits that reduced competition".

Without the funds, insurance companies insuring a large number of sick clients may be forced to raise premiums on all clients.

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"We were disappointed by the court's recent ruling". "New Yorkers aren't fooled". "This is one of several steps the Trump administration has taken to undermine the ACA". "It moves us back to some extent to the status quo where people with pre-existing conditions found it very hard to get insurance". "That will increase competition, and competition will help keep prices down".

"CMS has asked the court to reconsider its ruling, and hopes for a prompt resolution that allows CMS to prevent more adverse impacts on Americans who receive their insurance in the individual and small group markets", Verma said.

"We are very discouraged by the new market disruption brought about by the decision to freeze risk adjustment payments", AHIP stated. It added that the move comes at a critical time when insurance providers are developing premiums for 2019 and states are reviewing rates.

Reuters' characterization of the move is that "President Donald Trump's administration has used its regulatory powers to undermine Obamacare after the Republican-controlled Congress past year failed to repeal and replace the law".

"Based on guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare".

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Health insurers say it is a move that could drive up premium costs and create marketplace uncertainty. "It will undermine Americans' access to affordable coverage, particularly for those who need medical care the most". On the same day, Minuteman Health, Inc. filed a similar complaint in district court in MA.

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

In February, U.S. District Judge James Browning in Albuquerque, N.M., ruled that the formula used by CMS to calculate payments in the risk-adjustment program was flawed and had not been adequately justified by federal regulators.

"CMS is seeking a quick resolution to the legal issues raised and will inform stakeholders of any update to the status of collections or payments at an appropriate future date", the agency said.

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