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AHIP Statement On The Freeze Of Risk Adjustment Payments For The Individual And Small Group Markets

posted by Kristine Grow

on July 7, 2018

WASHINGTON, D.C. – America’s Health Insurance Plans (AHIP) issued the following statement following the Administration’s decision to freeze risk adjustment payments for the individual and small group markets, in light of the decision earlier this year by United States District Court for the District of New Mexico:

“We all agree that Americans deserve affordable, comprehensive coverage and care – regardless of whether they are sick, healthy, or have a pre-existing condition. Because different plans cover different people, the health of the people they serve differs as well. The risk adjustment program helps ensure coverage is available for high-need patients by sharing the cost of covering them. If a plan covers more patients who require more health care services, that plan receives funds from other plans that cover fewer high-need patients – all without using any taxpayer dollars.

“We are very discouraged by the new market disruption brought about by the decision to freeze risk adjustment payments. This decision comes at a critical time when insurance providers are developing premiums for 2019 and states are reviewing rates. This decision will have serious consequences for millions of consumers who get their coverage through small businesses or buy coverage on their own. It will create more market uncertainty and increase premiums for many health plans – putting a heavier burden on small businesses and consumers, and reducing coverage options. And costs for taxpayers will rise as the federal government spends more on premium subsidies.

“We agree that a quick resolution is needed to avoid greater harm to the individual and small group markets. More than ever, American businesses and families want affordable coverage and care they need and deserve. We encourage the Administration to reevaluate its decision and work with all stakeholders to make health care more affordable for all Americans.”

About AHIP

America’s Health Insurance Plans (AHIP) is the national trade association representing the health insurance community. AHIP’s members provide health and supplemental benefits to millions of Americans through employer-provided coverage, the individual insurance market, and public programs such as Medicare and Medicaid. AHIP advocates for solutions that expand access to affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality, and innovation. Visit www.ahip.orgfor more information.