Trump Administration Cuts Funding For Obamacare Navigator Program

Credit Kaiser Family Foundation

"Longer-term, I think that the administration's walk-back of risk-adjustment payments penalizes those payers that did, in fact, attempt to enroll participants without bias to health status, and unfortunately it also rewards those payers that for whatever reason chose to play it that much safer and do their best to recruit healthy individuals", Abrams says. FierceHealthcare subscribers rely on our suite of newsletters as their must-read source for the latest news, analysis and data impacting their world.

Not only is the administration gutting the program, it's making them help people enroll in the plans Trump has concocted that don't comply with the consumer protection standards and other requirements of the law. Under the Affordable Care Act, risk adjustment was meant to prevent insurers from turning away the sickest patients.

The suspension of risk adjustment payment will also have the effect of destabilizing the ACA marketplace.

Kavanaugh would not only be a critical vote on Texas, but also on dozens of health care cases pending in the lower courts which are likely to be appealed to the Supreme Court in upcoming terms. "And the reason that the penetration of value-based programs-even those that have upside-only risk-[has lagged] is that reluctance and the sense that they don't have deep capital reserves, aren't prepared and equipped to handle a significant financial shock like some sort of clawback because they missed their targets", Abrams says.

Seema Verma, administrator of the Centers for Medicare and Medicaid Services, listens during a meeting on healthcare reform at the White House.

The administration argued in its announcement that its hands were tied by conflicting court rulings in New Mexico and MA.

The cost of any increase in premiums that results from the risk adjustment payments may come from taxpayer dollars. The Maryland Insurance Administration has a hearing scheduled for July 31.

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"This is how health care disparities are exacerbated - we will be put in the very bad position of pitting populations that need assistance against each other in order to prioritize how we can use the resources", she said.

Trump's administration has used its regulatory powers to undermine the ACA on multiple fronts after the Republican-controlled Congress previous year failed to repeal and replace the law instituted by Democratic President Barack Obama. The question then isn't if insurers will get paid but when.

State officials, with bipartisan support from both Gov. Larry Hogan and the General Assembly, asked the federal agency this spring for permission to establish a reinsurance program that would create a $462 million fund for insurers to cover the most expensive claims. Insurance Commissioner Kreidler offered the following statement.

More than 20 million people have coverage through former President Barack Obama's law. This introduces uncertainty into the ACA markets just as insurers are deciding next year's rates.

She noted the Trump administration views state flexibility as important, and is committed to granting as much of it as possible. The other two methods were temporary, but risk adjustment is permanent.

Now that the risk adjustment payments are on hold, some state regulators fear that insurers could become less willing to participate in certain communities. In Maryland, Kaiser usually ends up paying CareFirst.

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