Minnesota health plans could take $71.7 million take from loss of ACA ‘risk adjustment’ payments
But a fourth health insurer here would be spared a big payment of nearly
On Saturday, the federal
The money comes from carriers that happen to insure healthier consumers in the markets, and is one of several measures in the ACA that were designed to promote market stability so private insurers would compete.
"As a result of this litigation, billions of dollars in risk adjustment payments and collections are now on hold," said CMS administrator
For 2017,
The national trade group for health insurers issued a statement Saturday saying the Trump administration's decision threatens the stability of health insurance markets. Risk adjustment is needed, the trade group said, because it helps make sure coverage is available for patient with costly medical problems by sharing those costs across all insurers.
"It will create more market uncertainty and increase premiums for many health plans -- putting a heavier burden on small businesses and consumers, and reducing coverage options," said
The risk adjustment program transfers funds among carriers in the individual market, which primarily serves people under age 65 who are self-employed or don't get coverage from an employer. It also applies to carriers in the market where small businesses buy coverage.
In a statement Saturday, CMS cited a February decision by the
"The ruling prevents CMS from making further collections or payments under the risk adjustment program, including amounts for the 2017 benefit year, until the litigation is resolved," CMS said in the statement.
CMS said that because of a contrary decision on the issue by the
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