Tuesday, 17 July, 2018


Health care premiums could rise following Trump administration's

Health care premiums could rise following Trump administration's Health care premiums could rise following Trump administration's
Patty Aguilar | 10 July, 2018, 22:04

Once again, the Trump administration has taken an axe to the Affordable Care Act, temporarily suspending a program that was set to pay out $10.4 billion to insurers for covering high-risk individuals past year.

At stake is more than $10 billion in "risk adjustment" payments - a feature of the 2010 health law that requires insurers with healthier consumers to reimburse plans that end up with costlier, sicker patients, so the market balances out.

Many Trump followers often cheer cuts to Obamacare, not knowing that the Affordable Care Act and Obamacare are one in the same.

While imperfect, the risk adjustment program "has helped promote market stability over the past five years", Wehrle said.

The pro-ACA group Protect Our Care issued a statement from its executive director, Brad Woodhouse, Saturday after the administration announced its decision regarding risk penalty payments, characterizing the move as further chipping away at the Affordable Care Act.

In the meantime, some health insurers are potentially out billions of dollars.

Trump's team is considering the move after a federal court decision found the formula for calculating the risk adjustment payments to be flawed.

Similarly, previous year the Trump administration ended Obamacare's cost-sharing reduction payments to health insurers. "CMS has asked the court to reconsider its ruling, and hopes for a prompt resolution that allows CMS to prevent more adverse impacts on Americans who receive their insurance in the individual and small group markets".

"We were disappointed by the court's recent ruling", Seema Verma, administrator for the Centers for Medicare and Medicaid Services (CMS), which administers the program, told The Wall Street Journal in a statement.

"An effective risk adjustment program is crucial to the sound operation of a health insurance marketplace in which individuals, families and small businesses with health needs have access to more affordable, high-quality coverage", said Bill Wehrle, Kaiser Permanente vice president of health insurance exchanges, in a statement.

The suspension comes as insurance companies are hammering out rates for the next enrollment period. The White House supported two attempts in Congress a year ago to repeal the program, which insures about 20 million Americans.

Serota noted that the payments are required by law, and said he believes the administration has the legal authority to continue making them despite the court cases.

Still, insurers are grappling with changes that the Trump administration and Congress have made to Obamacare for 2019.

It could encourage more insurers to bow out of the Affordable Care Act.

These moves are prompting some insurers to request premium hikes for 2019 in the double digits.

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