Administration Reverses Course, Reinstates Insurer Payments Just Weeks After Freezing Risk-Adjustment Program
The Trump administration halted the payments, citing a ruling out of New Mexico that the risk-adjustment program’s implementation was flawed and hadn’t been adequately justified by federal regulators. The move sparked widespread concern that the decision could cause further upheaval in the health law marketplaces.
The New York Times:
Trump Administration, In Reversal, Will Resume Risk Payments To Health Insurers
The Trump administration, in an abrupt reversal, said Tuesday that it would restart a program that pays billions of dollars to insurers to stabilize health insurance markets under the Affordable Care Act. The administration suspended the program less than three weeks ago, saying it was compelled to do so by a federal court decision in New Mexico. But the administration said Tuesday that it would restore the program because otherwise health plans could become insolvent or withdraw from the market, causing chaos for consumers. (Pear, 7/24)
The Associated Press:
Trump Administration To Resume 'Obamacare' Insurer Payments
About $10 billion is at stake through a premium stabilization program. Insurers with healthier-than-average customers pay into the program, and the money goes to insurers with sicker patients. No taxpayer subsidies are involved. The administration had faced widespread criticism for its original move, with insurers warning of premium increases and exits from the market. Republican lawmakers were concerned about political fallout affecting the midterm elections. (Alonso-Zaldivar, 7/24)
The Hill:
Trump Admin Restarts Key ObamaCare Payments
The administration’s surprise suspension of the risk adjustment payments earlier this month set off a round of warnings of rising premiums and condemnation from Democrats who said it was further GOP “sabotage” of the health-care law. This final rule makes no changes to the program, and essentially just restarts it after a short pause. (Weixel, 7/24)
The Wall Street Journal:
Trump Administration To Resume ‘Risk Adjustment’ Payments To Insurers
The new rule appears to clear the way for the planned flow this fall of risk-adjustment money tied to the 2017 plan year, a total that CMS had said amounted to $10.4 billion. “This rule will restore operation of the risk adjustment program, and mitigate some of the uncertainty caused by the New Mexico litigation,” said CMS Administrator Seema Verma. “Issuers that had expressed concerns about having to withdraw from markets or becoming insolvent should be assured by our actions today.” (Wilde Mathews, 7/24)
Politico:
Trump Administration To Resume Obamacare’s Insurer Payments
The risk adjustment program, created to protect Obamacare insurers that attract sicker and more expensive customers, has been targeted in court by some companies that allege it penalizes smaller startup health plans. A federal judge in one case partially agreed, ruling in February that HHS erred in requiring that the risk adjustment program be budget neutral. (Cancryn, 7/24)
Bloomberg:
Trump Administration Announces Fix For Halted Obamacare Payments
Among publicly-traded insurers, Centene Corp. and Molina Healthcare Inc. owe money to other insurers under the program, while Anthem Inc. is set to receive funds. CMS announced that the payments had been suspended on July 7. (Tracer, 7/24)
Modern Healthcare:
How States Are Defining Essential Health Benefits
Two states so far have taken advantage of the federal government's decision to give them more leeway in defining the essential health benefits that individual and small group insurers must offer consumers. Those states—Alabama and Illinois—diverged significantly in how they responded to that flexibility. In April, the CMS finalized a rule that would allow states to determine the minimum essential health benefits that individual and small business health plans operating in the state are required to cover, beginning in 2020. (Livingston, 7/24)
The Hill:
Fierce ObamaCare Critic Joins Trump Administration In Top Health-Care Role
Paul Mango, a former Pennsylvania gubernatorial candidate who is a fierce critic of ObamaCare, will join the Trump administration in a top health-care role. Mango will serve as chief principal deputy administrator and chief of staff at the Centers for Medicare and Medicaid Services (CMS), the agency that oversees health insurance markets. (Hellmann, 7/24)
