The Trump administration said Saturday that it is temporarily halting billions of dollars of payments created to help insurers meet the Affordable Care Act requirement that they provide coverage regardless of whether a person is healthy or sick.
The Centers for Medicare & Medicaid Services said today that the February action by the trial court in New Mexico "prevents CMS from making further collections or payments under the risk adjustment program, including amounts for the 2017 benefit year, until the litigation is resolved". All in all, the program was slated to shift $10.4 billion among insurers in 2017, according to the agency. Insurers say, the timing of the decision could mean higher premiums for millions of individuals and small businesses next year.
America's Health Insurance Plans, the trade organization representing health insurers, issued a statement saying it was "discouraged" by the decision to freeze risk adjustment payments.
"When the rules of the game change after the fact - insurers don't necessarily see the federal government as a particularly reliable partner right now", Levitt says. It's a move that could shake up insurance markets.
"This decision will have serious consequences for millions of consumers who get their coverage through small businesses or buy coverage on their own".
British Foreign Secretary Boris Johnson quits in protest over May's Brexit plan
Davis's resignation could embolden Brexit-supporting Conservative parliamentarians to challenge May's leadership. The staunchly pro-Brexit Conservative MP Andrea Jenkyns tweeted: "Fantastic news".
The program is critical to markets under the Affordable Care Act because insurers with healthier consumers enrolled in plans reimburse insurers with sicker and more expensive enrollees.
A February ruling from a federal court in New Mexico invalidated the risk adjustment formula, and a January ruling from a federal court in MA upheld it. In June, the administration said it wouldn't defend central portions of Obamacare in federal court, claiming that key provisions should be invalidated and that the individual mandate is unconstitutional. The government collects the money from health insurers with relatively healthy enrollees, who cost less to insure.
The administration has made several other moves in recent years to scale back or halt implementation of certain aspects of the ACA. 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.
The ripple comes at a pivotal time for the Affordable Care Act's marketplace.
But supporters of the ACA criticized the CMS announcement as the latest move by the Trump administration to undermine Obamacare.