A campaign to sabotage the Affordable Care Act took another step forward over the weekend when the Trump administration announced it will indefinitely suspend “risk adjustment payments.”
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.
“Risk adjustment payments” protect companies that insure a disproportionate number of people who need the most expensive health care. If there is an imbalance of high-risk customers among companies, the government uses a formula to redistribute money from less-burdened companies to more-burdened ones.
This is one way the ACA, also known as Obamacare, makes it possible for people who need particularly expensive care to get health insurance at an affordable rate. It discourages companies from trying to save money by cherry-picking the healthiest people and kicking others to the curb.
When the Republican-controlled Congress’ effort to repeal the ACA died last year, it appeared the law had survived. But the sabotage campaign, by finding one underhanded way after another to throw a wrench into the works of the law, has steadily driven up costs and pushed people off of Obamacare.
In Illinois, 106,000 people lost their insurance from 2016 to 2017. More will lose their insurance this year with this latest attack on the ACA. Premiums undoubtedly will rise, and more people will be unable to afford them. The Blue Cross Blue Shield Association says freezing the risk adjustment payments will raise premiums for millions of individuals and small business owners and might substantially shrink the number of health plan choices.
Technically, the administration has only suspended risk adjustment payments, not permanently ended them. But the justification was flimsy — a ruling last February by a judge in New Mexico that the government’s method of calculating the payments was flawed. The administration could just as easily have listened to a judge in Massachusetts who ruled the opposite way or awaited the results of an appeal.
Instead, the Trump administration has used the judge’s ruling in New Mexico as a pretext to destabilize the ACA.
Insurance companies are setting their rates now for the ACA’s November enrollment period, so the loss of risk adjustment payments is sure to drive up premiums regardless of whether the payments are resumed at some future point. President Donald Trump and the GOP will be that much closer to effectively killing Obamacare.
The suspension of risk adjustment payments won’t matter to people who quality for income-based federal subsidies, which rise along with premium costs. But people who earn too much to qualify could be priced out of insurance.
Meanwhile, costs will go up for the Cook County Health and Hospital Systems, which provides 50 percent of the charity care in the county.
If this offends you, call and write your local representative in Congress. They’re all up for re-election. Stiffing sick people is not the best way to win votes.
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