Heinrich: Trump Administration's Health Care Sabotage Will Increase Premiums For New Mexicans

Credit Kaiser Family Foundation

Credit Kaiser Family Foundation

The payments also were meant to try to prevent insurers from cherry-picking healthier patients to keep costs down.

As insurers gauge how the freezing of $10.4 billion in risk-adjustment payments could impact their financial performance, it's clear that their exposure varies significantly across the industry. "Again, previous year you heard a lot of that".

But Senator Ron Wyden, the ranking Democrat on the Senate Finance Committee, said encouraging navigators to promote plans that don't comply with the ACA is "federally funded fraud: paying groups to sell unsuspecting Americans on junk plans that allow insurance companies to deny care on a whim and charge whatever they want is nothing but a scam". "We aren't making any changes to our 2019 plans at this time", Greg Bury, a spokesman for Medica, said of the risk-adjustment program.

In its announcement, CMS said the private sector is more cost-effective, so people looking for health coverage should be encouraged to go to insurance agents and brokers (who may receive a commission, unlike navigators). "It will undermine Americans' access to affordable coverage, particularly those who need medical care the most".

All of this increases the risk payers take by participating in a federally sponsored program, and it makes it more hard for payers and providers to reach deals with which all parties are comfortable, he adds.

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Last August, federal health officials announced that they were reducing the navigators' aid by 41 percent, from $62.5 million, and slashing by 90 percent a related budget for advertising and other outreach activities to foster ACA enrollment. The CMS has appealed the decision, particularly because a MA court upheld such payments.

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

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.

In the 2019 filings, the state's largest insurance company, Anthem, will only offer catastrophic coverage in five counties next year. The Maryland Insurance Administration has a hearing scheduled for July 31.

"The longer we are in the market, the more confident we've gotten", Schlosser said.

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But combined with other recent actions by the Trump administration, the decision sets a negative tone, Hoagland said.

In past years, CMS announced funding opportunities in April and required navigator groups to apply for grants by mid-June. The judge was ruling in a case filed by a small nonprofit, which argued that the program's formula disproportionately favored big insurers.

Insurance Commissioner Al Redmer Jr. said that as of now he doesn't expect the latest decision to interrupt the state's rate-setting process.

Last month, President Trump announced the Department of Justice (DOJ) was supporting a lawsuit that challenges preexisting conditions protections under Obamacare. Her insurer, Oscar, is boosting rates again for 2019, and Williams is slated to see an increase to $518.33 for a low-level bronze plan.

"We have to be very cautious". There could have been a "substantive and thoughtful conversation" about what more needs to be done, she said.

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Now that the risk adjustment payments are on hold, some state regulators fear that insurers could become less willing to participate in certain communities.

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