Published: Fri, July 13, 2018
Medical | By Vicki Mclaughlin

Obamacare 'navigator' program cut further by Trump administration

Obamacare 'navigator' program cut further by Trump administration

Even so, enrollment under the health law has remained remarkably steady. Sign up today to get healthcare news and updates delivered to your inbox and read on the go.

The Centers for Medicare & Medicaid Services on Tuesday announced steep funding cuts for sign-up assistance through state-based programs called "navigators". All of these acts take direct aim at the heart of the Affordable Care Act and the viability of individual health insurance markets everywhere.

This time, the agency which conducts the medical insurance markets is slashing funds for organizations which assist individuals to search for the policy, forcing the classes to make do with roughly one-fourth of the national funding they obtained to this year's open enrollment.

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 president last fall issued an executive order to try to make it easier for individuals and small businesses to buy health plans that cost less than ACA coverage because they cover fewer services and bypass rules meant to protect people from previous practices in which insurers charged higher prices to women, older people and those with pre-existing medical conditions.

CMS administrator Seema Verma said in a statement the administration was "disappointed" in the February ruling and that CMS has asked the court to reconsider and "hopes for a prompt resolution that allows CMS to prevent more adverse impacts on Americans". But a month later a federal judge in New Mexico said it was.

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Speaking for the navigators, Fred Ammons, who supervises the Insure Georgia organization, said: "This is a huge cut to navigator programs across the country".

Insurance-industry groups are pushing the Trump administration to resolve a legal dispute that led to the suspension of billions of dollars of payments that help stabilize Obamacare's markets. The CMS has appealed the decision, particularly because a MA court upheld such payments.

Insurers decried the move, and have been pressing the administration to resolve the issue and resume the payments, arguing that premiums will rise for ObamaCare enrollees if funding is cut off. The other two methods were temporary, but risk adjustment is permanent. About 20 million Americans have received health insurance coverage through the program.

"The truth is that the Trump administration has lots of options". The insurers have requested average rate increases for 2019 that range from 18.5 percent to 91.4 percent, depending on the type of plan.

If the individual mandate is ruled unconstitutional, private insurance companies could revert to rejecting people with many conditions-including heart disease, cancer, diabetes and a host of less serious health problems-or charging them exorbitant rates for coverage. Small insurers often complain about risk adjustment payments because they end up paying their larger competitors, who tend to have the sickest patients. Until now, the grants have been used only to help people choose and buy ACA health plans or to help steer people with low incomes toward Medicaid.

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