Maryland insurers say Trump Administration to cut health payments destabilizes market

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The Trump administration said on July 7 that it would temporarily suspend some payments to health insurers under the Affordable Care Act's (ACA) risk adjustment program, in light of a ruling earlier this year by a federal district court in New Mexico.

The Centers for Medicare and Medicaid Services, the federal agency that oversees ACA funding, said in a statement that navigators are inefficient, signing up a fraction of all ACA customers, and unnecessary as the ACA enters its sixth year and the public is increasingly familiar with health insurance.

The payments are meant to help stabilise health insurance markets by compensating insurers that had sicker, more expensive enrollees in 2017. If there is an imbalance of high-risk customers among companies, the government uses a formula to redistribute money from less-burdened companies to more-burdened ones.

Levitt says the administration's announcement was "a little perplexing", given that the legal fight over the conflicting rulings in New Mexico and MA is still ongoing. No longer were insurers allowed to deny coverage or charge higher premiums for patients who suffered from costly preexisting conditions. But the justification was flimsy - a ruling last February by a judge in New Mexico that the government's method of calculating the payments was flawed.

It could encourage more insurers to bow out of the Affordable Care Act. "In general, when there's uncertainty in the market, insurers will cushion themselves however they can", she said. About 20 million Americans have received health insurance coverage through the program known as Obamacare.

The cost of any increase in premiums that results from the risk adjustment payments may come from taxpayer dollars. The move is yet another attempt to knock out one of the legs of Obamacare - creating a scenario where insurance companies have to accept all patients regardless of their health status, but will not be financially supported in doing so.

Florida Blue, an insurer that enrolls among the largest number of Obamacare consumers nationwide, said it won't miss the help from the federally funded grass-roots helpers.

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Insurance is normally based on risk, with premiums costing more for clients who are expected to require more healthcare services.

"People spin the administration's decision as Trump trying to do harm, but it's exactly the opposite", he added.

But since the Trump Administration removed the fine for not buying health insurance, Republicans argue that the removal of the threat of that "tax" now makes the law unconstitutional.

It also comes as insurers appeared to be warming back up to the ACA.

The Trump administration announced Tuesday it would could nationwide funding for navigators by 72 percent, from $36 million to $10 million.

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

These plans, however, aren't required to have the same consumer protections as ACA policies.

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