The cuts to grass-roots groups around the country were announced three days after health officials revealed that, because of a pending lawsuit, they were suspending a program created by the law to even out the burden on health insurers whose customers are especially unhealthy or sick. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.
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. These alternative plans don't have to provide all of the Affordable Care Act's consumer protections.
This time, the agency which conducts the medical insurance markets is slashing funds for organizations which assist individuals to search for the policy, forcing the classes to make do with roughly one-fourth of the national funding they obtained to this year's open enrollment.
The Trump administration's move "will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices", association president Scott Serota said in a statement. More will lose their insurance this year with this latest attack on the ACA.
Ceci Connolly, who runs the Alliance of Community Health Plans, said the administration could do more to ensure the payments are quickly made, such as issuing the interim final rule, or pursuing other legal avenues. The nonprofit insurer sued the government in 2016 claiming the risk adjustment program unfairly penalized smaller insurers.
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Citing two conflicting federal court cases on the use of statewide average premiums in its decision, CMS said it can not collect or redistribute funds for risk-adjusted payments.
Over the a year ago, the White House has issued a number of executive orders and undertaken administrative actions to undercut the program popularly known as Obamacare. "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". Insurers proposed rates in May. The administration could just as easily have listened to a judge in MA who ruled the opposite way or awaited the results of an appeal.
Payments and collections of risk adjustment payments and charges were scheduled to begin in August.
According to the America Health Insurance Plans trade group, there is also a high possibility that the premiums for a significant number of health plans will increase due to the market uncertainties involved with the current disruption inflicted on them.
Technically, the administration has only suspended risk adjustment payments, not permanently ended them. Until now, the grants have been used only to help people choose and buy ACA health plans or to help steer people with low incomes toward Medicaid.