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techkenyot.com July 17, 2018


Trump administration halts billions in insurance payments under Obamacare

11 July 2018, 05:22 | Silvia Roy

Justin Sullivan Getty Images North America

Fargo North Dakota. President Trump held a campaign style

The risk adjustment program redistributes funds from plans with lower-risk enrollees to plans with higher-risk enrollees. Almost half of us living in North Dakota have a pre-existing condition and could be found "left out in the cold" without insurance.

"We were disappointed by the court's recent ruling".

"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.

The Affordable Care Act's (ACA) "risk adjustment" program is meant to incentivize health insurers to cover individuals with pre-existing and chronic conditions by collecting money from insurers with relatively healthy enrollees to offset the costs of other insurers with sicker ones, according to Reuters.

"The risk adjustment formula was extremely biased in favor of large, established insurers and discriminated against new and small insurers, including co-ops like ours", Hickey told The New York Times on July 7.

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The administration said it was withholding $10.4 billion in the so-called "risk adjustment" payments, citing a district court ruling from earlier this year in New Mexico.

In the MA case, however, a federal judge upheld the Obamacare formula, the Journal reports.

"As a result of this litigation, billions of dollars in risk adjustment payments and collections are now on hold", she said.

For the past five years, when insurance has been available through ACA marketplaces for people who do not have access to affordable health benefits through a job, federal health officials have started every spring working with navigator groups on plans for the coming enrollment season. "It will create more market uncertainty and increase premiums for many health plans - putting a heavier burden on small businesses and consumers, and reducing coverage options".

President Barack Obama's signature law, the Affordable Care Act was signed into law in March 2010.

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The news comes on the heels of many predicting better days for insurers in the ACA markets.

CMS was referring to a February ruling from a federal court in New Mexico that invalidated the risk adjustment formula, and a January ruling from a federal court in MA that upheld it.

The bottom line is that the Trump administration is making good on its promise to rid Americans of Obamacare, with or without the help of the legislature.

CMS cites the late February court ruling in deciding to place a freeze on the $10.4 billion which it collected past year, and which ordinarily would be dispersed among high-risk insurers. These alternative plans don't have to provide all of the Affordable Care Act's consumer protections. The insurers have requested average rate increases for 2019 that range from 18.5 percent to 91.4 percent, depending on the type of plan.

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