Three Minnesota health plans face combined hit of $71.7 million
On Saturday, the federal
Health policy experts argue the federal agency could have responded to the ruling without freezing the transfers. Insurers, in turn, criticized the move, saying it could result in higher rates for consumers.
"It's ridiculous," said
Risk adjustment is one of three provisions in the Affordable Care Act (ACA) that were designed to promote competition in the insurance markets for individuals and small businesses -- two relatively small markets that underwent significant changes with the health law.
In
Risk adjustment has been used for years by the federal government in making payments to private insurers that operate Medicare health plans. The idea is that payments from carriers with relatively healthy enrollees are directed by the government to insurers that happen to attract enrollees who use more medical care.
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
"As a result of this litigation, billions of dollars in risk adjustment payments and collections are now on hold," CMS Administrator
But
Even
"If you're a company that has to pay in, do you have to pay in? How much do you have to pay in?" Laszewski asked. "If you're a company that's getting paid out, you've fronted that money expecting it -- you've got a real problem if they don't pay the money."
The financial impact for insurance companies varies.
For 2017,
Schowalter of the
Even so, Levitt said: "The administration has introduced quite a bit of uncertainty into this process."
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