Health Care Primer: The Sabotage And Retaliation Edition

Health Care Primer: The Sabotage And Retaliation Edition

The Affordable Care Act's (ACA) "risk adjustment" program is meant to incentivize health insurers to cover individuals with pre-existing and chronic conditions by collecting money from insurers with relatively healthy enrollees to offset the costs of other insurers with sicker enrollees. Known as the risk adjustment program, it allocates insurance premium dollars to plans that enrolled higher risk and less healthy members from plans that enrolled lower risk and healthier members. Also, the $16 million payment (for the 2017 plan year) is temporarily on hold, per CMS's order.

America's Health Insurance Plans, the main health insurance industry trade group, said in a statement that it is "very discouraged" by the Trump administration's decision to freeze payments. Health law experts are...

Every action the Trump administration has taken on Obamacare suggests that's their goal. The nonprofit insurer sued the government in 2016 claiming the risk adjustment program unfairly penalized smaller insurers.

The administration argued in its announcement that its hands were tied by conflicting court rulings in New Mexico and MA.

Some have said CMS is being deliberately disruptive because of its hostility to ObamaCare, and that government programs should not be at the mercy of a lone federal judge.

The ambiguity involved in the conflicting New Mexico and MA rulings may mean the suspension of payments will indeed be temporary. Typically, agencies publish proposed rules to allow time for public comment before they go into effect.

Nonetheless, the timing is problematic. Initial reports of sky-high premium increases have been offset somewhat by more recent reports of moderate increases, according to data from Kaiser Family Foundation. Small insurers often complain about risk adjustment payments because they end up paying their larger competitors, who tend to have the sickest patients. Rate filings by CT health insurers for 2019 are due next week. "It is important to keep in mind that the original risk adjustment payments are budget-neutral such that for some insurers to win, other insurers have to lose".

The suspension of risk adjustment payments won't matter to people who quality for income-based federal subsidies, which rise along with premium costs.

If the individual mandate is ruled unconstitutional, private insurance companies could revert to rejecting people with many conditions-including heart disease, cancer, diabetes and a host of less serious health problems-or charging them exorbitant rates for coverage.

The spending cut is only one shift that CMS announced Tuesday.

Not only is the administration gutting the program, it's making them help people enroll in the plans Trump has concocted that don't comply with the consumer protection standards and other requirements of the law.

The $10 million will be available to the 34 states that use the Federally-facilitated Exchange Navigator Program, which enables participants to find their optimal coverage package for Obamacare enrollment, which begins this fall.

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.

Related News:

  • Jackson's Nick Fury In Spider-Man: Far From Home?

    Jackson's Nick Fury In Spider-Man: Far From Home?

    Jackson just shared some fun Nick Fury photos on Instagram , including a flawless S.H.I.E.L.D. business card. That, and him saying "back to the familiar, the comfortable." suggests this Fury is no longer in the 1990s.
    Premier League Giants In 'Advanced Talks' Over Gareth Bale Transfer

    Premier League Giants In 'Advanced Talks' Over Gareth Bale Transfer

    It frustrated me not to be a starter in the Champions League final'. But I knew I was capable of being involved in the game and I was. We'll sit down in the summer and hopefully resolve this issue".

    Will Smith makes an extreme #InMyFeelingsChallenge video

    Will Smith woke up on his last day of vacation in Budapest in his feelings - and it's all because of Drake . Smith took the challenge and smashed it by climbing a bridge in Budapest and dancing on top of it.
  • Fairbanks Blockbuster closing as last two Alaska stores come to an end

    Fairbanks Blockbuster closing as last two Alaska stores come to an end

    The Alaska stores were apparently actually profitable, according to Deadline , but not enough to justify renewing their leases. The Anchorage Daily News reports the final two Blockbuster stores in the state announced Thursday they're calling it quits .
    Cosmic ‘ghost particle’ traced offering new ‘window on the universe’

    Cosmic ‘ghost particle’ traced offering new ‘window on the universe’

    The IceCube Laboratory is pictured at the Amundsen-Scott South Pole Station, in Antarctica, in 2017 and released on July 12, 2018. Scientists first started theorizing about neutrinos in the 1930s , and by 1956 , they confirmed their existence.

    'Downton Abbey' Movie Premiere Date, Cast and Spoilers

    Carnival Films is a division of NBCUniversal International Studios and one of the UK's leading drama producers. Brian Percival , who directed The Book Thief , About a Girl and the Downton Abbey pilot, will direct the film.
  • HuffPost Verdict: Theresa May's White Paper Pleases Neither Brussels Nor Brexiteers

    HuffPost Verdict: Theresa May's White Paper Pleases Neither Brussels Nor Brexiteers

    On top of that, the Brexit Steering Group suggested that May's plans are incompatible with the rules of the single market. That would avoid disruption to automakers and other manufacturers who source parts from multiple countries.
    Trump gears up for meeting with

    Trump gears up for meeting with "competitor" Putin after rocky North Atlantic Treaty Organisation summit

    It's very detailed", Macron said, according to the Associated Press. "It confirms the goal of 2 percent by 2024". Trump has said next week's meeting with Putin "may be the easiest" part of his European tour.

    Johnson & Johnson ordered to pay £3.6bn in talc asbestos cancer case

    A court in California ruled on a similar case against the cosmetics company previous year , calling on it to pay $ 417 million . The verdict was given by a jury in Missouri, US, and the pharmaceutical company also faces claims from 9,000 other people.
  • Trump claims victory in North Atlantic Treaty Organisation spending dispute

    Rosenstein said he had briefed Trump about the allegations earlier this week and said the timing of the announcement was a coincidence.
    Ewan McGregor's Daughter Insults His GF Mary Elizabeth Winstead

    Ewan McGregor's Daughter Insults His GF Mary Elizabeth Winstead

    Ewan McGregor's daughter Clara has branded his girlfriend Mary Elizabeth Winstead a "piece of trash" in a comment on Instagram . Clara added her own comment, writing, "Most lovely and talented woman on earth???" with some LOL emojis.

    Trump Makes Bizarre Claim that He's More Popular than Abraham Lincoln

    And when I say that I am talking about government because the people of the United Kingdom agree with me. President Donald Trump claims he's now more popular than President Abraham Lincoln . "Beating Lincoln.


Most liked

Coral Reefs Need Bird Poop, But Rat Infestations Threaten Seabird Population
Graham said that the results of the study show that rat eradication needs to be a high conservation priority on oceanic islands. Here's how the decimation of seabirds by rodents affects the health of nearby coral reefs.

MP Michael Fabricant apologises after sharing 'racist' Sadiq Khan tweet
He added: "They are just flags from some of the countries where my company had clients back in the 1980s". Fabricant said he found it "particularly galling as I am a socially liberal Conservative ".

Anderson keeps Wimbledon dream alive, reaches final
In the second semi-final also at Centre Court, world No 1 Rafael Nadal takes on three-time victor , Novak Djokovic. The match has surpassed the previous record of 4 hours, 44 minutes when the score was tied 9-9 in the deciding set.

Kylie Jenner fans create GoFundMe seeking donations to make her a billionaire
However, if the campaign goal isn't realized, people won't actually be spending any money on it - for now, it's only an act of internet satire.

What (if any) Uncharted news is Nathan Fillion teasing?
As you can see, the post features Canadian rapper Drake and the unmistakable motto of Sir Francis Drake "sic parvis magna". He also did voicework for the Halo franchise and more recently voiced Cayde-6 in Destiny.

LGBT Activists Display "Hidden Flag" At World Cup
Even Chelsea Clinton weighed in on Twitter , calling the project "courageous & handsome ". Six activists stand to represent the LGTBQ rights flag in Russian Federation .

Preschooler wrote own obituary before dying of rare cancer
An idea was born, and together the family started planning Garrett's send-off when his cancer was declared terminal in June. While undergoing treatment for his cancer, Garrett would prank medics - from using whoopy cushions to "hazing" interns.

TRANSFORMERS Spin-Off BUMBLEBEE Casts Two Villains
Respectively, they are Shatter , who will be voiced by Angela Bassett and Dropkick, voiced by Justin Theroux . The trailer of Bumblebee featured a third Deception, one who happens to take on the form of a red fighter jet.

Manchester United return to training before beginning United States tour
Diogo Dalot, a £19 million summer signing from Porto, will also be in the group. Inter Milan demanded around £48m for the attacker last summer.

ROH and NJPW holding MSG event during WrestleMania weekend
The event will run opposite the NXT Takeover event that will be held the same night in Brooklyn, New York at Barclays Center. The first WrestleMania happened at MSG, as have numerous other major pay-per-views and major moments for the company.

Britons back Trump on airing Brexit views
But within days, two senior ministers had quit, departures which Trump said earlier in the week had left Britain in turmoil. The President said the newspaper didn't include the "tremendous things" he said about Ms May in the interview.

Special Counsel Robert Mueller Indicts 12 Russians for Hacking
Trump, meanwhile, has been criticized for being reluctant to speak publicly about Russian interference into the campaign. Three Russian companies have also been charged, along with top Trump advisers Paul Manafort and Michael Flynn .

United Kingdom police confirm source of Novichok poisoning
Public health officials say the risk to the public is low, but advised people not to pick up any odd items. Police are still looking into where the bottle came from and how it came to be in Rowley's house.

Epic now gives Unreal Engine developers 88% of game profits
The Unreal Engine Marketplace has also seen a 30-percent growth in new sellers over the first half of 2018. A few creators have spoken up about the deal, showing nothing but support for it. "This is unreal.

Plumber who hit George Clooney claims he was blinded by the sun
On Wednesday, a rep for the actor told People , "George was treated and released from an Olbia hospital". With Amal's help, Clooney eased his way off the cart and leaned on an assistant as he walked to the jet.