Administration’s Freeze On Insurer Payments Rattles Some, But Experts Say Companies ‘Have Weathered Worse Storms’
Under the payment program, the federal government each year collects money from insurers in the health law marketplaces who had healthier customers and redistributes the funding to insurers with sicker, more expensive customers. The administration over the weekend suspended the payments, citing a judge's ruling that the program was flawed.
Politico:
Latest Obamacare Shake-Up Could Fuel Rate Hikes
The Trump administration’s latest blow to Obamacare is rattling health insurers as they draw up rate proposals, sparking new worries about huge premium increases just before midterm elections. The administration’s decision to freeze a $10 billion program designed to protect insurers from big losses in Obamacare injected more volatility into insurance marketplaces, which President Donald Trump’s health department has sought to undermine. And the move swiftly drew new warnings from insurers that higher premium increases could soon follow when enrollment reopens in November. (Demko, 7/9)
Modern Healthcare:
CMS Risk-Adjustment Payment Freeze To Hit High-Cost Insurers Hardest
The Trump administration's latest shock to the Obamacare system by freezing more than $10 billion in 2017 risk-adjustment transfers has even small companies that don't benefit from the program lambasting the CMS. The risk-adjustment program has long divided insurers, as larger plans with more-sophisticated data teams and a longer history in the market have raked in more money to pay for their higher-cost patients. But even smaller carriers are framing the move as an eleventh-hour, arbitrary whiplash for the exchanges. Some analysts worry the move also signals a shift away from the Affordable Care Act's core tenet of guaranteed issue as it threatens a financial toll for insurers with older, sicker enrollees. (Luthi, 7/9)
The Star Tribune:
Without ACA Adjustment Pay, Minn. Health Plans Could Take $71.7M Hit
In Minnesota, about 150,000 people this year are buying coverage in the individual market, which primarily serves people under age 65 who are self-employed or don't get coverage from an employer. About 310,000 state residents are covered by small employer health plans, which cover 50 people or less. Risk adjustment has been used for years by the federal government in making payments to private insurers that operate Medicare health plans. The idea is that payments from carriers with relatively healthy enrollees are directed by the government to insurers that happen to attract enrollees who use more medical care. (Snowbeck, 7/9)
Georgia Health News:
Insurers Caught Off Guard By Feds’ Freeze Of ACA ‘Sickness’ Payments
In a weekend announcement, the Trump administration said it’s freezing payments under an Affordable Care Act program aimed at protecting insurers who have sicker patients from financial losses. The Centers for Medicare & Medicaid Services said a federal court ruling that was handed down in February would force it to suspend what are known as risk-adjustment payments, worth about $10.4 billion for 2017. (Miller, 7/9)
The Baltimore Sun:
Maryland Insurers Say Trump Administration To Cut Health Payments Destabilizes Market
Maryland’s health insurance companies are concerned that a Trump administration decision to suspend payments that help to cover the costs of the sickest patients will further destabilize the market and could push them to seek even higher premiums on plans consumers already say are too expensive. The Centers for Medicare & Medicaid Services announced over the weekend that it was freezing billions of dollars in so-called risk adjustment payments for plans under the Affordable Care Act, also known as Obamacare, because of a court decision earlier this year that deemed the formula for determining these payments unlawful. (McDaniels, 7/9)
California Healthline:
Health Insurers Struggle With Sudden Freeze On ACA Payouts
Health insurers and Covered California officials are facing another curveball from the Trump administration on the Affordable Care Act that could rattle the insurance market. Over the weekend, Seema Verma, administrator for the U.S. Centers for Medicare and Medicaid Services, said she was suspending a $10-billion program that helps stabilize the insurance markets created under the health law. (7/10)
