Trump Administration May Stop Risk-Adjustment Payments Under Obamacare


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Julia Cohen Reporter
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The Trump administration may soon stop risk-adjustment payments, which were created under the Obamacare to stabilize the individual health insurance market, according to a Friday Wall Street Journal Report.

The Centers for Medicare and Medicaid Services (CMS) were supposed to put out a report detailing the newest round of risk-adjustment payments at the end of June, but never did so, according to The Wall Street Journal.

The potential move comes after the standing risk-adjustment plan was struck down by the United States District Court of New Mexico for having a flawed reimbursement formula. (RELATED: Government to Spend $17 Billion On Insurance Subsidies In 2018)

Obamacare’s risk-adjustment program was created to stabilize the market across plans with higher risk patients and lower risk patients, according to a Kaiser Family Foundation explainer from August 2016. The program “redistributes funds from plans with lower-risk enrollees to plans with higher-risk enrollees.”

Suspending the program may help some insurers, but hurt others. “Some pay into it and don’t get money back, so a suspension wouldn’t likely be a financial challenge,” the Wall Street journal report states.

Still, pro-Obamacare health care experts are panicking over the potential move.

“This is aggressive and needless sabotage of the ACA. Impact likely chaos,” Andy Slavitt, former acting administrator of CMS under former President Barack Obama tweeted on Friday night.

Insurance filings for next year reflected “an array of projections,” according to the Wall Street Journal, and show that “insurers are expanding their ACA offerings into new regions.”

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