Government Healthcare Policy, Business and Technology

CMS risk-adjustment payment freeze to hit high-cost insurers hardest

Modern Healthcare: The Trump administration's latest shock to the Obamacare system by freezing more than $10 billion in 2017 risk-adjustment transfers has even small companies that don't benefit from the program lambasting the CMS.

The risk-adjustment program has long divided insurers, as larger plans with more-sophisticated data teams and a longer history in the market have raked in more money to pay for their higher-cost patients. But even smaller carriers are framing the move as an eleventh-hour, arbitrary whiplash for the exchanges. Some analysts worry the move also signals a shift away from the Affordable Care Act's core tenet of guaranteed issue as it threatens a financial toll for insurers with older, sicker enrollees.

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