Billions of dollars in payments to health insurers under the Obamacare health care law were stopped Saturday by the Trump administration.
The court's ruling bars the agency from collecting or making payments under the current methodology, which uses a statewide average premium, said CMS, which is part of the Department of Health and Human Services.
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. All in all, the program was slated to shift $10.4 billion among insurers in 2017, according to the agency.
The program transfers funds from lower-risk enrollee plans to higher-risk ones, allowing the market to spread risk evenly. While the administration says it is required to stop payments because of the court decision, insurers say the move could result in higher premiums for millions of individuals and small businesses. "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", AHIP said. "And costs for taxpayers will rise as the federal government spends more on premium subsidies". "It moves us back to some extent to the status quo where people with pre-existing conditions found it very hard to get insurance".
Many Trump followers often cheer cuts to Obamacare, not knowing that the Affordable Care Act and Obamacare are one in the same.
"This action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices", Serota said in a statement.
"Republicans are doing a bang up job ensuring they are properly blamed for health care rate hikes this fall", Matt House, a spokesman for Senate Democratic Leader Chuck SchumerCharles (Chuck) Ellis SchumerAn end game on Supreme Court nominations Liberals forget Constitution as Supreme Court battle fires up Anti-Trump protesters sing national anthem outside rally MORE (N.Y.), said in a Monday tweet".
The goal of the payouts was to encourage all insurers to participate in the Obamacare exchanges and enroll all kinds of customers versus only targeting young, healthy people, according to the report.
"I think insurers are going to be watching very closely what the administration says in court, and whether this is a sign of further steps to undermine the law, or a good faith effort to try to comply with the judge's order", he says. In June, the administration said it wouldn't defend central portions of Obamacare in federal court, claiming that key provisions should be invalidated and that the individual mandate is unconstitutional.