Medicine

Trump health chief defends suspending ObamaCare payments

Trump health chief defends suspending ObamaCare payments

The Trump administration announced Tuesday it is making further cuts to the "navigator" program that provides in-person assistance to people seeking coverage on Obamacare's web-based marketplace. Many of those are self-employed people and small-business owners, generally seen as a Republican constituency.

In its announcement, the CMS reprised arguments it made previous year that navigators, which operate with the annual grants in the 34 states that rely on the ACA's federal insurance exchange, have been ineffective and are less important than they once were: "As the exchange has grown in visibility and become more familiar to Americans seeking health insurance, the need for federally funded navigators has diminished". In a surprise weekend announcement, the Trump administration temporarily suspended $10 billion worth of 2017 "risk adjustment payments".

But the Trump administration is hanging its decision to withhold subsidies to insurers on court decisions from New Mexico and MA which say the way those payments are handed out is too vague. The move is the latest effort by the Trump administration to undermine the Affordable Care Act.

The president last fall also issued an executive order to try to make it easier for individuals and small businesses to buy health plans that cost less than ACA coverage because they cover fewer medical services and bypass the law's rules meant to protect people from old insurance practices in which companies had charged higher prices to women, older people, and those with preexisting medical conditions.

But multiple insurers have issued statements in recent days saying the decision will likely force some companies to raise rates. The agency also said that the people confused by health insurance benefits can use insurance agents and brokers for help. That's because many ACA customers will qualify for federal government premium subsidies, which are still alive and well in Obamacare. In January a federal court in MA ruled the formula wasn't arbitrary and capricious.




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 latest "Obamacare" flare-up does not affect most people with employer coverage. 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.

America's Health Insurance Plans, another large industry group, declined to comment. The Kaiser Family Foundation estimates that 27 percent of people under the age of 65 have what could be considered a pre-existing condition. The other half are covered by expanded Medicaid.

The GOP repeal drive collapsed last summer after Sen.

Even so, enrollment under the health law has remained remarkably steady. Taken together, these moves will have the effect of damaging the ACA's marketplaces by attracting younger, healthier people, while forcing older, sicker people to either pay more for insurance or purchase sub-par insurance that might not cover services they need.


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