This is distinct from the debate over ObamaCare's cost-sharing payments, which the Trump Administration cut off past year after a federal judge barred the subsidies that Congress had not appropriated. It is clear that the target is not the individual mandate-which in fact funnels millions of dollars from paying customers to the insurers' coffers-but the health care legislation itself.
The move is just the latest in a line of decisions by the Trump administration to undermine the ACA.
Now that the risk adjustment payments are on hold, some state regulators fear that insurers could become less willing to participate in certain communities.
The calculated risk adjustment payment for 2017 was $10.4 billion, according to CMS. It discourages companies from trying to save money by cherry-picking the healthiest people and kicking others to the curb.
The plan would replace federal payments to insurance companies with block grants to states, allowing states to "innovate" by providing low-cost, low-benefit plans. Many have started making a profit and some are expanding their involvement for 2019, a marked change from this time previous year, when several carriers said they were going to pull out of the exchanges for 2018.
The Trump administration announced Tuesday it is making further cuts to the "navigator" program that provides in-person assistance to people seeking coverage on Obamacare's web-based marketplace.
However, the trade group America's Health Insurance Plans (AHIP) said in a statement that the recent move would lead to uncertainty and increase premiums, putting the burden on small businesses and consumers. Texas could reach the Court in an upcoming term, potentially placing Kavanaugh in a crucial role to determine whether Americans with pre-existing conditions have the right to access affordable, quality health care.
If the individual mandate is ruled unconstitutional, private insurance companies could revert to rejecting people with many conditions-including heart disease, cancer, diabetes and a host of less serious health problems-or charging them exorbitant rates for coverage. Insurers proposed rates in May.
And to win a federal grant for next year, navigator organizations will have to be willing to steer the public away from the Affordable Care Act to consider other options, like association health plans and short-term temporary insurance that the Trump Administration is promoting as a cheaper alternative to the ACA.
"Costs for taxpayers will rise as the federal government spends more on premium subsidies", the group said.
Democrats were quick to denounce the administration's latest action. Sen.
Centers for Medicare and Medicaid Service announced the abrupt halt of these payments Saturday evening, citing a February 2018 ruling from the U.S. District Court for the District of New Mexico that invalidates them.
CMS Administrator Seema Verma says the navigators just aren't cost effective.
More than 10 million people buy individual health insurance plans through HealthCare.gov and state insurance marketplaces. Health law experts are... Many of those are self-employed people and small-business owners, generally seen as a Republican constituency.
Blue Shield of California is owed the most at $696 million, followed by BCBS of Florida at $686 million and HCSC, a Blues-affiliated insurer, at $640 million.
But despite President Donald Trump's disdain for "Obamacare", enrollment for subsidized private coverage has been fairly steady, with about 10 million people now signed up.
By the way, this rule was propagated by the Obama Administration, not President Trump. The other half are covered by expanded Medicaid. The administration called the program ineffective and said advertising from insurers themselves can help make up for the reduced funding. Such actions by the current administration are happening amid enrollment and setting of health plans for the next season.