In announcing a more than 70 percent funding cut from a year ago, the Centers for Medicare and Medicaid Services said in a notice that the marketplace navigator groups should be able to "stretch their funding further" with less demand for in-person assistance because the marketplace is more familiar to most Americans.
Molina and Centene could each avoid $1 billion in payments into the pool for 2017, according to Jefferies. The industry warned that the government's failure to make the payments would likely push up premium rates on 2019 plans.
President Donald Trump's administration has used its regulatory powers to undermine the ACA on multiple fronts after the Republican-controlled Congress previous year failed to repeal and replace the law propelled by Democratic President Barack Obama.
When the Republican-controlled Congress' effort to repeal the ACA died past year, it appeared the law had survived. Supporters of the health law called the move another sign of the administration's determination to undermine the ACA.
The suspension of risk adjustment payment will also have the effect of destabilizing the ACA marketplace.
The federal agency's decision to suspend collections and payments until litigation is resolved is a short-term problem for Anthem, an insurer "that historically benefits from the risk adjustment program", Harris said.
Though insurers may eventually get the funds once the administration revises the formula, the move is sending shudders through the industry.
Thai cave rescue: Rick Stanton says he is 'not a hero'
During the rescue, some Thais said on social media the soccer team had been reckless in entering the cave during the rainy season. During the mission to save the boys, a former Thai Navy SEAL Saman Kunam died after volunteering to lend his expertise.
The administration, however, was not compelled to halt the payments on the basis of this ruling.
But in January, in a separate case, a federal district judge in MA upheld the government formula used to calculate the payments.
Blue Shield of California is owed the most at $696 million, followed by BCBS of Florida at $686 million and HCSC, a Blues-affiliated insurer, at $640 million.
"Given the continued attacks on healthcare, including federal rules allowing the resurgence of low-priced, junk health insurance plans, such as "association health plans" and "short-term plans", consumers looking for good, comprehensive coverage could be easily confused", Frederick Isasi, executive director of Families USA, a Democrat-leaning healthcare advocacy organization, told CNN.
Last month, President Trump announced the Department of Justice (DOJ) was supporting a lawsuit that challenges preexisting conditions protections under Obamacare. They are now deciding which exchanges they will participate in next year and what premiums they'll charge. These are people who are not going to go to an insurance agent or broker. The mandate was created to stabilize the health insurance market by encouraging younger and healthier Americans to sign up for insurance, and the repeal could consequently have the opposite effect. Removal of the tax penalty rendered the individual mandate unenforceable. It is clear that the target is not the individual mandate-which in fact funnels millions of dollars from paying customers to the insurers' coffers-but the health care legislation itself. These limited benefit plans will compete directly with the comprehensive insurance on the exchanges, and navigators will be forced to sell consumers on them. "It moves us back to some extent to the status quo where people with pre-existing conditions found it very hard to get insurance". Pregnancy could be one of these. The agency has worked with insurers to address their concerns and to adjust the formula under both the Obama and Trump administrations.
"I fear this latest decision, if it stands, will lead to fewer choices for consumers and higher premiums they would pay for health plans in 2019". The reality is sick people do rack up more health care costs. The Maryland Insurance Administration has a hearing scheduled for July 31. She's hoping to land a full-time job with health insurance before she has to renew her coverage.