Experts: Trump administration's suspension likely won't delay risk adjustment payments

The Trump administration’s latest move over the weekend to suspend risk adjustment payments isn't likely to delay payouts to insurers, healthcare experts said Monday. (American Enterprise Institute)

The Trump administration’s latest move over the weekend to suspend risk adjustment payments to insurance companies garnered plenty of raised eyebrows but isn't likely to delay payouts to insurers, healthcare experts said Monday.

“The announcement on Saturday that the administration is going to hold off on risk adjustment payments is, I think, unnecessary and will likely increase premiums and reduce insurer participation," said Timothy Jost, a Washington and Lee University professor emeritus who closely follows the ACA.

He was speaking at an event hosted in Washington, D.C., by conservative-leaning think tank American Enterprise Institute on Monday.

Conference

2019 Drug Pricing and Reimbursement Stakeholder Summit

Given federal and state pricing requirements arising, press releases from industry leading pharma companies, and the new Drug Transparency Act, it is important to stay ahead of news headlines and anticipated requirements in order to hit company profit targets, maintain value to patients and promote strong, multi-beneficial relationships with manufacturers, providers, payers, and all other stakeholders within the pricing landscape. This conference will provide a platform to encourage a dialogue among such stakeholders in the pricing and reimbursement space so that they can receive a current state of the union regarding regulatory changes while providing actionable insights in anticipation of the future.

Jost called the New Mexico decision "completely crazy." 

"I’m troubled by the Trump administration saying we’re not going to pay anybody anything until we get this litigation sorted out,” Jost said.  Even so, Jost said, he believes it could come to a resolution before insurers are impacted.

"I think there’s a 100% chance the payout will come when it otherwise would have come in the fall unless the Trump administration decides this is a good way to throw a wrench into the whole thing," he said. "There’s no reason why they can’t get this resolved or put out an interim final rule if they have the will to do it."

RELATED: New Mexico CO-OP earns favorable ruling in risk-adjustment lawsuit against HHS

Other insurance experts questioned the New Mexico ruling and its potential impact on the Affordable Care Act. Seth Chandler, who is a professor of law at the University of Houston Law Center—who acknowledged he’s “not known to be great ACA fan”—said he found the judge's ruling in the case "mysterious."

Suggested Articles

Health insurers’ financial performance is on a continuing upward trend, but political and legal risks could pose a threat to that growth.

Senate lawmakers released a draft package of legislation aimed at curbing healthcare costs they said they believe they can pass on a bipartisan basis.

Attorneys general seeking to defend the ACA argue that their opponents—including the DOJ—have poor legal standing to challenge the law.