It also said last year's cuts had minimal impact, as year-over-year enrollment dipped slightly, to 11.8 million from 12.2 million, and that navigators enrolled less than 1 percent of HealthCare.gov customers overall. The ruling barred Centers for Medicare and Medicaid Services (CMS) from making further collections or payments under the program, including amounts for the 2017 benefit year, until the litigation is resolved.
Rising premiums in the marketplaces created by the health law are enticing insurers, who are looking past the political turbulence and a curveball this weekend from the Trump administration.
Over the weekend, the administration said it would freeze risk adjustment payments to insurers that cover a large amount of unhealthy consumers - payments meant to stabilize the marketplace by offsetting higher costs associated with riskier patients.
In other words, Medicaid, CHIP and whatever other federal assistance is provided would be transformed into voucher programs, which has been the main aim of Trump and congressional Republicans.
However, the trade group America's Health Insurance Plans (AHIP) said in a statement that the recent move would lead to uncertainty and increase premiums, putting the burden on small businesses and consumers. The strategy can also help the companies control costs because the hospitals and insurers both benefit from lower medical spending.
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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.
The latest "Obamacare" flare-up does not affect most people with employer coverage.
The elimination of risk adjustment funds also comes as Maryland officials await a decision from CMS on another funding mechanism they believe would help stabilize the market and provide money to insurers to help pay for expensive patients. The so-called "risk adjustment" program takes payments from insurers with healthier customers and redistributes that money to companies with sicker enrollees. "And the reason that the penetration of value-based programs-even those that have upside-only risk-[has lagged] is that reluctance and the sense that they don't have deep capital reserves, aren't prepared and equipped to handle a significant financial shock like some sort of clawback because they missed their targets", Abrams says.
Anthem, one of the largest carriers in the individual market, could lose out on $500 million in payments, according to a JPMorgan analyst estimate. They did not return requests for comment. The judge was ruling in a case filed by a small nonprofit, which argued that the program's formula disproportionately favored big insurers.
Speaking for the navigators, Fred Ammons, who supervises the Insure Georgia organization, said: "This is a huge cut to navigator programs across the country".
"So much uncertainty put in the market at this point of time is very unnerving", said Ritu Agarwal, senior associate dean of research at the University of Maryland Robert H. Smith School of Business, who follows the health care system.
On Thursday the Centers for Medicare and Medicaid Services (CMS) announced the latest effort to send ACA markets into the proverbial death spiral.