Trump administration halts billions in insurance payments under Obamacare

11 Juillet, 2018, 05:24 | Auteur: Yves Courtet
  • Trump administration freezes Obamacare payments, citing court decision

Democrats say that the cuts are more evidence of Trump officials sabotaging the health law.

The Centers for Medicare and Medicaid Services said it had to put the payments on hold, after a US district court judge ruled the government arrived at the formula that guides the payouts in a flawed way. According to advocates of ACA, also known as Obamacare, the risk adjustment program helps to ensure coverage is available for high-need patients by sharing the cost of covering them.

The Center for Medicare and Medicaid Services (CMS) has suspended payments to health insurers with a large number of sick Obamacare clients.

The risk-adjustment program, which does not cost taxpayers any money and is required by law, is created to ensure that health care coverage is available for sicker, higher-cost patients by sharing the cost of covering them. But a month later a federal judge in New Mexico said it was.

The Trump administration has made no secret of its hostility to the healthcare program, enacted in 2010. It's a move that could shake up insurance markets.

"This decision will have serious consequences for millions of consumers who get their coverage through small businesses or buy coverage on their own".

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Levitt says the administration's announcement was "a little perplexing", given that the legal fight over the conflicting rulings in New Mexico and MA is still ongoing.

Maryland's health insurance companies are concerned that a Trump administration decision to suspend payments that help to cover the costs of the sickest patients will further destabilize the market and could push them to seek even higher premiums on plans consumers already say are too expensive.

"This decision comes at a critical time when insurance providers are developing premiums for 2019 and states are reviewing rates". The left is complaining that HHS halted the payments too casually, but on all the evidence the Trump Administration is trying to abide by the ruling while the courts resolve the dispute.

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.

On July 29, 2016, New Mexico Health Connections filed a complaint in district court in New Mexico arguing that the use of the statewide average premium was "arbitrary and capricious". The CMS, which noted that a federal court in MA found its formula fair, has asked the New Mexico court to reconsider its decision and said it is seeking a quick resolution to the legal issue.

CMS plans to appeal the court's ruling, as the U.S. District Court for the District of MA ruled to uphold the payments. The CMS has asked Judge Browning to reconsider his ruling and is awaiting a decision.

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