The Trump administration said Saturday it’s freezing payments under an “Obamacare” program that protects insurers with sicker patients from financial losses, a move expected to add to premium increases next year.
At stake are billions in payments to insurers with sicker customers.
In a weekend announcement, the Centers for Medicare and Medicaid Services said the administration is acting because of conflicting court ruling in lawsuits filed by some smaller insurers who question whether they are being fairly treated under the program.The so-called “risk adjustment” program takes payments from insurers with healthier customers and redistributes that money to companies with sicker enrollees. Payments for 2017 are $10.4 billion. No taxpayer subsidies are involved.
The idea behind the program is to remove the financial incentive for insurers to “cherry pick” healthier customers. The government uses a similar approach with Medicare private insurance plans and the Medicare prescription drug benefit.
Major insurer groups said Saturday the administration’s action interferes with a program that’s working well.
The Blue Cross Blue Shield Association, whose members are a mainstay of Affordable Care Act coverage said it was “extremely disappointed” with the administration’s action.