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Trump Administration Continues War On People With Pre-Existing Conditions By Suspending Billions In Risk Payments

By July 11, 2018No Comments

This weekend, President Trump made another move in his war on health care. He suspended risk adjustment payments that help insurance companies offer more affordable coverage to everyone, regardless of if they are healthy or sick. By refusing to make risk adjustment payments — even though they don’t cost the taxpayer a single penny — President Trump and his Administration are making it harder for people with pre-existing conditions to access coverage, and driving up premiums for millions.


  • Chicago Sun-Times Editorial: Trump Administration Yanks Health Care Away From Even More Americans. [7/10/18]
  • Wall Street Journal: Trump’s Latest Affordable Care Act Move Adds To Insurers’ Uncertainty. [7/8/18]
  • Los Angeles Times: Another Challenge For Obamacare — And A Bigger Bill For Taxpayers. [Los Angeles Times, 7/10/18]
  • Politico: Latest Obamacare Shake-up Could Fuel Rate Hikes. [Politico, 7/9/18]
  • New York Times: Health Insurers Warn Of Market Turmoil As Trump Suspends Billions In Payments. [7/7/18]
  • NPR: Trump Administration Freezes Payments Required By The Affordable Care Act. [NPR, 7/8/18]
  • Washington Post: Trump Administration Takes Another Major Swipe At The Affordable Care Act. [7/7/18]
  • Los Angeles Times: Trump Administration Freezes Billions Of Dollars In Payments To Obamacare Insurers. [7/8/18]
  • NPR: Why Health Insurance Premiums May Rise Next Year. [NPR, 7/9/18]
  • Associated Press: Trump Administration Takes Another Swipe At Obamacare.[Associated Press, 7/9/18]
  • USA Today: Trump Administration Freezes Payments Required By Affordable Care Act, Health Care Premiums Could Rise. [7/8/18]
  • Fortune: Trump Administration Freezes Payments To Affordable Care Act Insurers With Sicker Patients. [7/8/18]
  • Bloomberg: Trump Health Officials Toss Obamacare Insurers Another Curveball.[7/7/18]
  • Slate: It Sure Looks Like The Trump Administration Is Trying To Sabotage Obamacare Again. [7/8/18]
  • Bustle: What Does Trump’s Freeze On Obamacare Payments Mean? Premiums Could “Significantly Increase.” [7/9/18]


  • Baltimore Sun: Maryland Insurers Say Trump Administration To Cut Health Payments Destabilizes Market. [7/9/18]
  • Chattanooga Times Free Press: Obamacare Payment Change Raises Worries For Individual Rates. [7/11/18]
  • Indianapolis Business Journal: Anthem Could Take Big Hit From Halt To Risk-Adjustment Payments. [7/10/18]
  • Star Tribune: Three Minnesota Health Plans Face Combined Hit Of $71.7 Million. [7/9/18]
  • Rutland Herald: ACA Changes Worry Vermont Health Care Officials. [7/9/18]
  • Georgia Health News: Insurers Caught Off Guard By Feds’ Freeze Of ACA ‘Sickness’ Payments. [7/9/18]
  • California Healthline: Health Insurers Struggle With Sudden Freeze On ACA Payouts. [7/10/18]
  • Associated Press: South Dakota Insurers May Take Hit After Payment Freeze. [7/10/18]


America’s Health Insurance Plans: Decision To Halt Payments “Will Create More Market Uncertainty And Increase Premiums For Many Health Plans.” “We are very discouraged by the new market disruption brought about by the decision to freeze risk adjustment payments. This decision comes at a critical time when insurance providers are developing premiums for 2019 and states are reviewing rates. This decision will have serious consequences for millions of consumers who get their coverage through small businesses or buy coverage on their own. It will create more market uncertainty and increase premiums for many health plans – putting a heavier burden on small businesses and consumers, and reducing coverage options. And costs for taxpayers will rise as the federal government spends more on premium subsidies.” [AHIP, 7/7/18]

Sabrina Corlette, Health Policy Researcher At Georgetown: Administration Is Throwing Wrench Into Critical Program Whose Goal Is To Protect People With Pre-Existing Conditions Against Discrimination. “The government opted for ‘throwing a monkey wrench into a critical program whose primary goal is to protect people with pre-existing conditions from discrimination by insurers.’” [Minneapolis Star Tribune, 7/9/18]

Chicago Sun-Times: This Is Bad News For All Americans Who Believe Nobody Should Be Priced Out Of Basic Health Care To Save The Rest Of Us Buck. “That’s bad news for the chronically ill, the disabled, the elderly and all others whose health care costs can run considerably higher than average. It’s bad news, as well, for all Americans who believe that nobody should be priced out of basic health care just to save the rest of us a buck.” [Chicago Sun-Times, 7/10/18]

Blue Cross Blue Shield Association: “Without Quick Resolution On This Matter, This Action Will Significantly Increase 2019 Premiums For Millions.” “Without a quick resolution to this matter, this action will significantly increase 2019 premiums for millions of individuals and small business owners and could result in far fewer health plan choices. It will undermine Americans’ access to affordable coverage, particularly for those who need medical care the most…The action taken today will create turmoil not only for those in the individual market – particularly as insurers finalize their offerings for the next open enrollment that begins in November – but also for the millions of businesses that rely on the small group market to provide affordable insurance options for their employees.” [Blue Cross Blue Shield Association, 7/7/18]

Bill Wehrle, Kaiser Permanente Vice President Of Health Insurance Exchanges: Effective Risk Adjustment Program Is “Crucial,” Especially For Those With Pre-Existing Conditions. “An effective risk adjustment program is crucial to the sound operation of a health insurance marketplace in which individuals, families and small businesses with health needs have access to more affordable, high-quality coverage…It enables the country to move away from a market where plans compete to avoid covering or charge more to people with preexisting health conditions, to one where competition is based on quality, affordable care for everyone.” [Baltimore Sun, 7/9/18]

Larry Levitt, Senior Vice President of Kaiser Family Foundation: “This Is One Of Several Steps The Trump Administration Has Taken To Undermine The ACA.” “‘Insurers hate uncertainty, and when faced with it tend to raise premiums to hedge their bets,” says Larry Levitt, Senior Vice President at the Kaiser Family Foundation. He says halting the risk adjustment program will disrupt the individual markets, and might even cause insurers not to participate next year. ‘When the rules of the game change after the fact – insurers don’t necessarily see the federal government as a particularly reliable partner right now,’ Levitt says. ‘This is one of several steps the Trump administration has taken to undermine the ACA.'” [NPR, 7/8/18]

Rodney Whitlock, Vice President of Health Policy At ML Strategies And Former Republican Congressional Aide: Administration’s Goal Is To Make Marketplace As Inhospitable As Possible For Participating Plans. “‘What you have to keep in mind is ultimately the intent of the administration,’ Whitlock says. “The executive order the president signed, not long after he got to the White House after the [Inaugural] Parade was effectively, ‘We’re declaring war on the Affordable Care Act.'” Whitlock says, the goal has been to make the marketplace as inhospitable as possible for participating plans, and this is just one more step in that direction.” [NPR, 7/8/18]

Washington Post: “The Suspension Of These Payments Is The Most Recent Maneuver By The Trump Administration To Undercut The Health-Care Law That President Trump Has Vowed Since His Campaign To Demolish.” “The suspension of these payments is the most recent maneuver by the Trump administration to undercut the health-care law that President Trump has vowed since his campaign to demolish. A Republican-led Congress last year failed to repeal much of the ACA. The administration has been taking steps to dismantle it through executive powers.” [Washington Post, 7/7/18]

Nicholas Bagley, University of Michigan Law Professor: “This Is No Way To Run A Health Program, And No Way To Run A Government.” “In another sense, however, the needless suspension of the risk adjustment program is a signal that the Trump administration remains intent on sabotage. Already, insurers were stiffed on their risk corridor money. Then the cost-sharing payments evaporated. Now, even risk adjustment money may go up in smoke. What’s next? This is no way to run a health program, and no way to run a government.” [Nicholas Bagley, 7/9/18]

Los Angeles Times: Halted Risk Payments Will Burden Taxpayers. “But it will be painful for at least two groups of Americans. The first includes the people who aren’t covered by a large employer’s plan and who earn too much money to qualify for federal subsidies. They’d be facing higher premiums anyway, thanks to the rising cost of healthcare. But the increase will be larger than it should be courtesy of the Trump administration’s handling of this issue…Meanwhile, people who earn less than 400% of the federal poverty level — for a family of four, that’s about $100,000 — are eligible for subsidies under the ACA that hold their premiums to a percentage of their personal income. No matter how much premiums go up, the subsidies absorb the change. As a consequence, the higher premiums rise, the more the subsidies cost federal taxpayers. Those are people who’ll bear most of the cost of freezing the risk adjustment transfers.” [Los Angeles Times, 7/10/18]

Risk Adjustment Decision Fits With Broader Pattern Of Trump Administration Using Courts To Sabotage ACA. “It’s hard not to wonder, though, whether someone in the White House belatedly realized this case was another untapped opportunity to spook insurers into spiking premiums, finding creative ways to repel sick people or leaving the market altogether. That would fit neatly into the administration’s broader pattern of using court cases as excuses to undermine the Affordable Care Act, after all. The others include killing reimbursements to insurers for subsidies for lower-income people, and refusing to defend the law’s protections for those with preexisting conditions.” [Washington Post, 7/9/18]

NPR: Not Surprising Trump Sided With New Mexico Given Republicans Have Been “Trying To Kill The Affordable Care Act For Quite A Long Time.” “It’s a little bit confusing because the court ruling was back in February. There’s an order in – out of New Mexico that said the formula for making the payments was unfair. But there’s a second court order in Massachusetts that held the opposite. So HHS seems to have chosen which side to take. They chose the New Mexico ruling, which isn’t all that surprising because the Trump administration up until now – and even Republicans before Trump became president – have been trying to kill the Affordable Care Act for quite a long time.” [NPR, Kodjak, 7/9/18]