Trump's administration has used its regulatory powers to undermine the ACA on multiple fronts after the Republican-controlled Congress past year failed to repeal and replace the law instituted by Democratic President Barack Obama.
Health insurance lobbying groups said halting the so-called risk-adjustment program could cause some companies to stop selling plans in some markets or boost premiums even more.
"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.
As insurers gauge how the freezing of $10.4 billion in risk-adjustment payments could impact their financial performance, it's clear that their exposure varies significantly across the industry.
All of this increases the risk payers take by participating in a federally sponsored program, and it makes it more hard for payers and providers to reach deals with which all parties are comfortable, he adds. These plans have been allowed under the law, but can only last a limited duration of three months, but the administration is going to publish a regulation in the coming weeks allowing consumers to enroll in these plans for a full year.
The federal government forms for applying for health coverage are seen at a rally held by supporters of the Affordable Care Act, widely referred to as "Obamacare", outside the Jackson-Hinds Comprehensive Health Center in Jackson, Mississippi, U.S. on October 4, 2013. They are now deciding which exchanges they will participate in next year and what premiums they'll charge.
Sen. Ron Wyden of OR, the ranking Democrat on the Senate Finance Committee, said in a statement that urging navigators to promote non-ACA plans amounts to "federally funded fraud: paying groups to sell unsuspecting Americans on junk plans that allow insurance companies to deny care on a whim and charge whatever they want is nothing but a scam". "It will undermine Americans' access to affordable coverage, particularly those who need medical care the most". It's also taken other actions recently that will increase costs.
CareSource Vice President Scott Brockman says continuing to tweak Obamacare creates additional uncertainty about the program's future.
The navigators, Fann added, were needed more in 2013 and 2014 when the marketplaces were in their first years and millions of people who hadn't bought insurance before were considering the health law's new options. "It is important to keep in mind that the original risk adjustment payments are budget-neutral such that for some insurers to win, other insurers have to lose".
Anthem, one of the largest carriers in the individual market, could lose out on $500 million in payments, according to a JPMorgan analyst estimate. Anthem declined comment on its specific circumstances. The nonprofit insurer sued the government in 2016 claiming the risk adjustment program unfairly penalized smaller insurers. "There is just one twist after another".
The new reduction of help for navigators, announced late Tuesday afternoon by the Centers for Medicare and Medicaid Services, fits within a pattern of moves by the administration to weaken the sweeping health-care law that President Trump has vowed to demolish.
Since President Trump took office, his administration has waged an all-out attack on Americans with pre-existing conditions. There could have been a "substantive and thoughtful conversation" about what more needs to be done, she said.