Earlier this week, the administration said it would half funding to a "risk adustment" program that reimburse health insurers that covered individual with more expensive medical conditions. That's why Obamacare included several provisions to help insurers cover the costs of the sickest patients - among them, the risk adjustment program.
"Yes, the money matters, but what's more important is (insurers) being clear on the rules of the road so they can run a business properly", said Ceci Connolly, CEO of the Alliance of Community Health Plans, an industry group for nonprofit, community-based insurers.
When payments are put on hold, however-as the Centers for Medicare & Medicaid Services announced Saturday would happen for the 2017 benefit year-it creates a list of potential winners and losers. Back in February, a federal judge partially agreed with the insurer and barred the government from making further collections or payments using its current formula.
Many carriers have already filed preliminary rate requests with state regulators - with some asking for double-digit hikes to shield themselves from other actions the administration and Congress have taken.
They say the moves will siphon healthier customers out of the Obamacare markets, raising premiums for everyone, and that Republicans will pay a political price for the moves in this November's mid-term elections. The ACA also prohibits insurers from rejecting applicants with pre-existing conditions and from charging older people exorbitantly high rates because they are higher financial risks. While nonprofits operating under the navigator program were previously forbidden from recommending particular health plans, now groups that apply for the grants will be expected to encourage people to buy association health plans or short-term insurance plans.
Trump's latest move could push Obamacare premiums higher
While imperfect, the risk adjustment program "has helped promote market stability over the past five years", Wehrle said.
A professor who follows Obamacare said it is unclear if the payments' suspension will result in higher premiums. And the number of insurers planning to offer policies through the Obamacare exchanges has increased. There could have been a "substantive and thoughtful conversation" about what more needs to be done, she said. "It's time for the navigator program to evolve, which is why we are announcing a new direction for the program today", said CMS administrator Seema Verma. This year they helped sign up almost 520,000 people for health insurance sold through the ACA exchange in North Carolina. States also have to prove to CMS that navigators met enrollment goals and provided information to consumers about all possible health plan options.
"Given the continued attacks on healthcare, including federal rules allowing the resurgence of low-priced, junk health insurance plans, such as "association health plans" and "short-term plans", consumers looking for good, comprehensive coverage could be easily confused", Frederick Isasi, executive director of Families USA, a Democrat-leaning healthcare advocacy organization, told CNN.
This is distinct from the debate over ObamaCare's cost-sharing payments, which the Trump Administration cut off previous year after a federal judge barred the subsidies that Congress had not appropriated.
Photo by Associated Press /Times Free Press.
Trump praises British PM Theresa May after criticizing her in newspaper interview
May told reporters the two would be discussing "our special relationship, which is great between the U.K. and the United States". The sting was greater for the fact that May was using the dinner to pitch her case for a separate trade arrangement.