WASHINGTON — The Trump administration’s move to suspend billions of dollars in payments that insurers expect under the Affordable Care Act injects new uncertainty into the health law’s insurance markets right as the companies are making decisions about next year’s rates.
The Centers for Medicare and Medicaid Services said Saturday it was forced to halt further collections or payments under the ACA program known as risk adjustment, because of a federal judge’s ruling. Initially, the decision could affect $10.4 billion in payments tied to the 2017 benefit year, which were scheduled to flow this fall.
The insurance industry also warned it would likely push up rates on 2019 plans. The payments are drawn from insurers with a preponderance of relatively healthy customers to subsidize those with a larger contingent of less-healthy policyholders.
America’s Health Insurance Plans, a trade group that represents insurers, said it was “very discouraged by the new market disruption brought about by the decision to freeze risk adjustment payments.” CMS officials didn’t specify how long the suspension would last or what would trigger a resumption of payments in the program. CMS officials said they are looking for a quick resolution to the legal issues raised.
An expanded version of this report appears on WSJ.com.
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