For the past five years, when insurance has been available through ACA marketplaces for people who do not have access to affordable health benefits through a job, federal health officials have started every spring working with navigator groups on plans for the coming enrollment season.
In listing examples of the kinds of groups eligible to apply for the money that remains, the CMS did not mention the grass-roots nonprofits that have done most of this work.
"Risk adjustment payments" protect companies that insure a disproportionate number of people who need the most expensive health care.
The law requires most Americans to have health insurance and provides federal financial subsidies for lower- and middle-income applicants who buy individual policies on federal or state exchanges, but the mandate will be phased out next year.
They say the moves will siphon healthier customers out of the Obamacare markets, raising premiums for everyone, and that Republicans will pay a political price for the moves in this November's mid-term elections.
CMS is freezing $10.4 billion in Affordable Care Act risk-adjusted payments, created to stabilize the insurance market by redistributing money to insurers with higher-cost members. Arnam said many people spend considerable time learning about health insurance options from a navigator, but enroll later at home.
But in January, in a separate case, a federal district judge in MA upheld the government formula used to calculate the payments.
"Investors should read headlines about the delay in risk adjustment payments cautiously", she said.
The suspension of risk adjustment payment will also have the effect of destabilizing the ACA marketplace.
The Trump White House has been busy separating migrant families and plotting the demise of Roe v. Wade in recent weeks, but don't worry: they haven't forgotten about their quest to make it harder for Americans to obtain adequate health insurance. The administration is also pushing to broaden the definition of short-term insurance, which is also exempted from the ACA's rules.
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. But a month later a federal judge in New Mexico said it was. 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.
But CareFirst and Kaiser could ask to adjust their rates higher given the Trump administration's decision.
Technically, the administration has only suspended risk adjustment payments, not permanently ended them.
The cost of any increase in premiums that results from the risk adjustment payments may come from taxpayer dollars.