The Trump administration will resume a program that pays billions of dollars to health insurers, just weeks after sending insurers into a panic by abruptly suspending the payments.
The federal Centers for Medicare and Medicaid Services (CMS) late Tuesday said it has adopted an interim final rule that will allow the agency to provide $10.4 billion in “risk adjustment” funding to insurers to help them provide coverage to particularly sick and costly enrollees.
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In a statement, CMS said that “taking immediate action to allow for the continued operation of the risk adjustment program is imperative to maintain stability and predictability in the individual and small group health insurance markets.”
The administration’s surprise suspension of the risk adjustment payments earlier this month set off a round of warnings of rising premiums and condemnation from Democrats who said it was further GOP “sabotage” of the health-care law.
This final rule makes no changes to the program, and essentially just restarts it after a short pause.
“This rule will restore operation of the risk adjustment program, and mitigate some of the uncertainty caused by the New Mexico litigation,” CMS Administrator Seema Verma said in a statement.
“Issuers that had expressed concerns about having to withdraw from markets or becoming insolvent should be assured by our actions today. Alleviating concerns in the market helps to protect consumer choices,” Verma said.
The administration cited as its reason for stopping the payments a court ruling from a federal judge in New Mexico finding that the administration had not fully justified its formula for dispensing the funds.
Experts said the payment freeze should not have a significant long-term impact, as it was resolved in only a couple weeks.
The risk adjustment program does not involve taxpayer funds. Instead, money is collected from insurers that have healthier enrollees overall and then given to insurers with sicker, more expensive enrollees to help cover their costs.