ACAP Condemns Suspension of Risk Adjustment Payments by CMS

FOR IMMEDIATE RELEASE: July 10, 2018
FOR MORE INFORMATION: Wyeth Ruthven (for Jeff Van Ness) – (202) 744-2679

ACAP CONDEMNS SUSPENSION OF RISK ADJUSTMENT PAYMENTS BY CMS

WASHINGTON—Today, the Association for Community Affiliated Plans (ACAP) condemned the Trump administration decision to suspend payments to Marketplace insurers under the risk adjustment program of the Affordable Care Act.

“At every turn, the Trump administration has chosen to inject more uncertainty and instability into the health care Marketplace,” stated ACAP CEO Margaret A. Murray. “The suspension of risk adjustment payments is the most significant destabilizing factor yet introduced, and was implemented in violation of statute and HHS’ own regulations. By introducing still more uncertainty just before plans must file rates for 2019, the Trump administration has likely impacted whether some plans will remain in the Marketplace. Enrollees may face a spike in premiums, as issuers must account for this new level of political uncertainty.”

The risk adjustment program is intended to ensure that issuers are not penalized if disproportionately unhealthy consumers enroll with them. There are real policy questions as to whether the risk adjustment formula is working as intended; however, the way to resolve such questions is not to disregard the law and simply suspend such payments and cause chaos.

About ACAP
ACAP represents 62 Safety Net Health Plans, which provide health coverage to more than 21 million people in 29 states. Safety Net Health Plans serve their members through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Marketplace and other health programs. For more information, visit www.communityplans.net

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