Trump administration slashes funding for Obamacare outreach program

Kenny Tucker
July 15, 2018

Insurers rely on the funding, which serves as a backstop for those who wind up with a high share of costly enrollees. The payments also were meant to try to prevent insurers from cherry-picking healthier patients to keep costs down. The other two, which were created to last only three years, ended after 2016.

Sen. Ron Wyden of OR, the ranking Democrat on the Senate Finance Committee, said in a statement that urging navigators to promote non-ACA plans amounts to "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".

Over the weekend arrived some fresh political fury that the Trump Administration is trying to sabotage ObamaCare by suspending something called "risk adjustment" payments.

Republicans remain eager to gut the Affordable Care Act, but some health plans say there's no time like the present to be in the Obamacare business.

Navigators are usually members of nonprofit and community organizations. "It will undermine Americans' access to affordable coverage, particularly those who need medical care the most".

There has been no demonstrable outrage from leading Democrats on Trump's intensifying campaign to transform Medicaid into a cut-rate voucher program or other aspects of the administration's crusade against the poor and dismantling of what remains of the social safety net.

Trump administration officials said they were forced to make the cuts after a federal court in New Mexico ruled in February that the formula for calculating risk adjustment could not use a statewide average premium.

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The federal Centers for Medicare and Medicaid Services will temporarily freeze payments for the so-called "risk-adjustment" program that takes money from insurers and redistributes it to companies with more expensive patients.

Centene and Wellmark didn't respond to requests for comment on the risk adjustment suspension.

Susanna Williams, a self-employed consultant who lives in Brooklyn, has seen her monthly spending on health insurance climb from $400.37 in 2015 to $470.80 this year, even as she downgraded her coverage to save money.

The Florida group will need to make hard choices about who they serve during open enrollment period that begins in November. The administration is also pushing to broaden the definition of short-term insurance, which is also exempted from the ACA's rules.

To fully understand the administration's latest move, a little history is in order. During the a year ago of the Obama administration, 17 navigators enrolled fewer than 100 people at an average cost of $5,000 per enrollee.

Some co-ops have sued on grounds that the funding formula is unfair to small insurers. The announcement comes in the midst of the annual rate-filing period when insurers announce their estimated premium prices and plans for coverage to state regulators.

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. The Republican Congress failed to repeal it, so the Trump administration has redoubled its efforts to gut it. And the number of insurers planning to offer policies through the Obamacare exchanges has increased.

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