Published: Wed, July 11, 2018
Medicine | By Douglas Stevenson

Trump administration halts billions of dollars of ACA payments

Trump administration halts billions of dollars of ACA payments

Small insurers often complain about risk adjustment payments because they end up paying their larger competitors, who tend to have the sickest patients.

The mainstream media report offered more criticism from supporters of the Affordable Care Act.

In a separate statement, the CMS said it was "disappointed" by the court's ruling, adding that "billions of dollars in risk adjustment payments and collections are now on hold". Almost half of us living in North Dakota have a pre-existing condition and could be found "left out in the cold" without insurance.

Navigators and other advocates push back on that claim, saying that navigators help enroll some of the people who most need help, such as those who don't speak English well or those in rural areas. The agency says the court ruling also prevents it from collecting additional risk-adjustment funds until the issue is resolved. "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", CMS Administrator Seema Verma said in a July 7 statement. The news comes in the wake of a ruling by a U.S. District Court judge in New Mexico which says the Center for Medicare and Medicaid Services (CMS) payment program is legally flawed.

In what now seems a rather prophetic statement, a senior vice president of the Kaiser Family Foundation cited the government involvement as the major factor in keeping the market from stabilizing.

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

The Trump administration has suspended more than $10 billion in Obamacare payments to insurance companies that lost money on state insurance exchanges. "And costs for taxpayers will rise as the federal government spends more on premium subsidies", the group said. They assisted 42% of enrollees, the agency said. Health law experts are... The administration has to have a legal justification for their actions. These alternative plans don't have to provide all of the Affordable Care Act's consumer protections. "Following through with this latest act of sabotage could raise rates for all consumers even more - on top of the rate hikes they have already caused - and is without a doubt an escalation in the Trump administration's war on people with pre-existing conditions".

Martin Hickey, the founder of New Mexico Health Connections, the state's health care co-op and the company that filed the lawsuit, believes the court ruling will reduce the prices and benefit consumers.

The administration's funding for such outreach had already been slashed past year to well below the $63 million budgeted annually under former President Obama.

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