"Longer-term, I think that the administration's walk-back of risk-adjustment payments penalizes those payers that did, in fact, attempt to enroll participants without bias to health status, and unfortunately it also rewards those payers that for whatever reason made a decision to play it that much safer and do their best to recruit healthy individuals", Abrams says. Premiums undoubtedly will rise, and more people will be unable to afford them. Another federal judge upheld the risk adjustment formula in a separate case filed in MA.
"I have not heard any of this", said Catherine Edwards, executive director of the Missouri Association of Area Agencies on Aging, which has spread navigator money to groups across that state and took a 62 percent cut in funding a year ago.
That's because the federal government won't distribute $10.4 billion it was expected to give insurers this fall under the Affordable Care Act's risk adjustment program. Scott Serota, president and CEO of The Blue Cross Blue Shield Association, said in a statement, "Without a quick resolution to this matter, this action will significantly increase 2019 premiums for millions of individuals and small-business owners and could result in far fewer health plan choices".
By the way, this rule was propagated by the Obama Administration, not President Trump. These are people who are not going to go to an insurance agent or broker. It is clear that the target is not the individual mandate-which in fact funnels millions of dollars from paying customers to the insurers' coffers-but the health care legislation itself.
President Donald Trump and the GOP will be that much closer to effectively killing Obamacare.More news: Partisan Divide Deepens Over Trump’s Supreme Court Pick
Rumors that the Trump administration would freeze payments were circulating late last week. The payments encouraged health insurers to enroll more consumers in plans and offered some financial help to cover the costs of individuals with higher medical care.
These plans, however, aren't required to have the same consumer protections as ACA policies. The Maryland Insurance Administration has a hearing scheduled for July 31.
A spokeswoman for the state Insurance Department said the agency is not commenting because officials are reviewing the federal government's announcement. This is another act of sabotage by the administration.
The navigators, Fann added, were needed more in 2013 and 2014 when the marketplaces were in their first years and millions of people who hadn't bought insurance before were considering the health law's new options. The government uses a similar approach with Medicare private insurance plans and the Medicare prescription drug benefit. The mandate was created to stabilize the health insurance market by encouraging younger and healthier Americans to sign up for insurance, and the repeal could consequently have the opposite effect. Block grants to the states would be based on ACA subsidies and the cost of Medicaid expansion "as of a fixed date", i.e., frozen, putting "federal spending on real budget", according to the plan.
The administration's latest effort to undermine the Affordable Care Act comes at a particularly sensitive time for insurers. Until now, the grants have been used only to help people choose and buy ACA health plans or to help steer people with low incomes toward Medicaid.