CMS Cuts ACA Navigator Funding Grants by $26M for 2019

  • CMS Cuts ACA Navigator Funding Grants by $26M for 2019

CMS Cuts ACA Navigator Funding Grants by $26M for 2019

Some of Blue Cross Blue Shield's biggest affiliated insurers would be the hardest hit by the Trump administration's decision to freeze more than $10 billion in risk adjustment payments. Having a risk adjustment program factors into these calculations.

"The reluctance of provider organizations to take on risk has always been I think the principal obstacle here".

It's a reversal from a year ago, when insurers exited some states as losses mounted and President Donald Trump vowed to dismantle the program.

Bright and Oscar both said that despite the move, they're going ahead with their expansion plans.

This is distinct from the debate over ObamaCare's cost-sharing payments, which the Trump Administration cut off past year after a federal judge barred the subsidies that Congress had not appropriated.

The move is just the latest in a line of decisions by the Trump administration to undermine the ACA. The funding will also be provided to each organization based on their success levels for enrollment, a measure CMS said would "ensure accountability within the program and avoid rewarding grantees that have failed to meet performance measures".

The navigators, Fann added, were needed more in 2013 and 2014 when the marketplaces were in their first years and millions of people who hadn't bought insurance before were considering the health law's new options.

But multiple insurers have issued statements in recent days saying the decision will likely force some companies to raise rates. But the justification was flimsy - a ruling last February by a judge in New Mexico that the government's method of calculating the payments was flawed.

The most radical plan drafted by congressional Republicans last year-known as the Graham-Cassidy bill after two of its authors, Lindsey Graham (South Carolina) and Bill Cassidy (Louisiana)-would basically eliminate the ACA's private insurance marketplaces as well as Medicaid expansion, replacing them with lower-funded state block grants with few strings attached. "We've been sending people to navigators", Israel said.

"Longer-term, I think that the administration's walk-back of risk-adjustment payments penalizes those payers that did, in fact, attempt to enroll participants without bias to health status, and unfortunately it also rewards those payers that for whatever reason chose to play it that much safer and do their best to recruit healthy individuals", Abrams says.

"President Trump indicated his support for the plan the day after its publication, tweeting: "...on conservative health plan: "'The White House fully supports the efforts of the broad coalition from around the country working to address the Obamacare disaster and increase affordable healthcare options for middle-class Americans'".

Navigators applying for the federal money will now be asked how they educate customers on new alternatives to the ACA that were put in place by the Trump administration. The assault on pre-existing condition protections may make its way to the Supreme Court soon, and if Brett Kavanaugh is sitting on the bench, affordable health care for all will be at serious risk.

Critics deride such plans as "junk insurance". "There is a need to analyze insurers case-by-case and account for their competitive landscapes", said Tinglong Dai, an associate professor of operations management and business analytics at the Johns Hopkins University Carey Business School.

Kaiser Health News (KHN) is a national health policy news service.