CMS Cuts ACA Navigator Funding Grants by $26M for 2019

Credit Kaiser Family Foundation

Credit Kaiser Family Foundation

In 2016, funding for navigator groups was $63 million, so the most recent funding cut represents an 80% reduction from two years ago. But the Trump administration is hanging its decision to withhold subsidies to insurers on court decisions from New Mexico and MA which say the way those payments are handed out is too vague. The Centers for Medicare and Medicaid Service said Saturday it was halting the payments due to a judge's ruling.

Now that the risk adjustment payments are on hold, some state regulators fear that insurers could become less willing to participate in certain communities.

Molina, on the other hand, won't have to send almost $1 billion, while Centene can avoid paying hundreds of millions of dollars to the program ... at least for now, JPMorgan projected. It discourages companies from trying to save money by cherry-picking the healthiest people and kicking others to the curb. The government uses a similar approach with Medicare private insurance plans and the Medicare prescription drug benefit. The program was also cut a year ago. Last fall President Trump signed an executive order expanding access to association health plans and short-term limited-duration insurance. Typically, agencies publish proposed rules to allow time for public comment before they go into effect. The ACA also prohibits insurers from rejecting applicants with pre-existing conditions and from charging older people exorbitantly high rates because they are higher financial risks.

The Trump administration is cutting most of the funds previously provided to groups that help people get health insurance under the Affordable Care Act and will push them to promote plans lacking the law's benefits and protections, a government agency said on Tuesday.

"Costs for taxpayers will rise as the federal government spends more on premium subsidies", the group said.

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Signaling the administration's long-term objectives, Andrew Bremberg, who oversees domestic policy at the White House, told reporters previous year, "The president still firmly believes that Congress must act to repeal and replace Obamacare, but before that can be done, this administration must act to provide relief". Following the decision, CMS asked the court to reconsider its ruling. Under the risk adjustment program, insurers with healthier policyholders contribute money, which is then divvied up among carriers with sicker ones.

"It's time for the Navigator program to evolve, which is why we are announcing a new direction for the program today", Verma said in a statement. This year they helped sign up almost 520,000 people for health insurance sold through the ACA exchange in North Carolina. Many of those are self-employed people and small-business owners, generally seen as a Republican constituency. "It has also led to upstarts, small plans and unprofitable ones paying billions of dollars to larger, more established and profitable insurers".

More than 20 million people have coverage through former President Barack Obama's law. In addition, both President Donald Trump and Senate Majority Leader Mitch McConnell have, in the past, supported the idea that insurers should not consider preexisting conditions when delivering coverage.

There has been no demonstrable outrage from leading Democrats on Trump's intensifying campaign to transform Medicaid into a cut-rate voucher program or other aspects of the administration's crusade against the poor and dismantling of what remains of the social safety net.

CMS said the cuts are warranted because Americans have grown more aware of the marketplace, and navigators enrolled fewer than 1 percent of the 12 million Americans who signed up for coverage under Obamacare this year.

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