Trump Regime Halts Risk Adjustment Payments to Health Insurers

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Trump Regime Halts Risk Adjustment Payments to Healthcare Insurers

by Stephen Lendman (stephenlendman.orgHome – Stephen Lendman)

The Trump regime is hellbent on destroying Obamacare, wanting it replaced with a greater pay or die scheme than under ACA – costing more, providing less, leaving countless millions more Americans uninsured or way underinsured.

His America First agenda excludes ordinary people, exploiting them to make privileged ones richer – including himself, his family members and cronies.

He ordered so-called risk adjustment payments to insurers suspended (likely prelude to eliminating them entirely), creating marketplace and consumer household uncertainty.

Risk adjustment under Obamacare is all about insurers competing on price and quality, not cherrypicking healthy enrollees at the expense of others with pre-existing conditions.

Insurers in markets with sicker-than-average overall enrollment receive compensation for their higher costs – payments coming from plans with healthier-than-average people less costly for insurers to cover.

Risk adjustment is essential for Obamacare to work – despite ACA’s serious flaws. Eliminating this crucial part of the program would jeopardize its viability, what Trump’s scheme is all about.

It’s unclear how it affects current ACA enrollees. On Friday, the Wall Street Journal reported about Trump’s likely intention to suspend risk adjustment payments to insurers (ordered on Saturday), saying:

“The suspension of some payouts under the program, known as risk adjustment, could come in the wake of a recent decision by a federal judge in New Mexico, who ruled that part of its implementation was flawed and hadn’t been adequately justified by federal regulators, people familiar with the plans said.”

Centers for Medicare and Medicaid Services (CMS) administrator Seema Verma expressed disappointment with the court ruling, saying:

“(B)illions billions of dollars in risk adjustment payments and collections are now on hold,” adding:

“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.”

Blue Cross and Blue Shield Association senior vice president Justine Handelman responded to Trump’s order, saying his “action to stop disbursements under the risk adjustment program will significantly increase 2019 premiums for millions of individuals and small-business owners, and could result in far fewer health plan choices.”

“It will undermine Americans’ access to affordable care, particularly for those who need medical care the most.”

Protect Our Care director Brad Woodhouse said the Trump regime “keeps pushing (its) destructive repeal-and-sabotage agenda, no matter the cost to the American people.” 

“Following through with this latest act of sabotage could raise rates for all consumers even more.” They’re already unaffordable for millions of households.

Ahead of Trump’s order, health insurance companies began announcing double-digit 2019 premium increases.

For many households, they’ll be substantially higher with the suspension of risk adjustment payments to insurers.

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Stephen Lendman
Stephen Lendman
Stephen Lendman was born in 1934 in Boston, MA. In 1956, he received a BA from Harvard University. Two years of US Army service followed, then an MBA from the Wharton School at the University of Pennsylvania in 1960. After working seven years as a marketing research analyst, he joined the Lendman Group family business in 1967. He remained there until retiring at year end 1999. Writing on major world and national issues began in summer 2005. In early 2007, radio hosting followed. Lendman now hosts the Progressive Radio News Hour on the Progressive Radio Network three times weekly. Distinguished guests are featured. Listen live or archived. Major world and national issues are discussed. Lendman is a 2008 Project Censored winner and 2011 Mexican Journalists Club international journalism award recipient.