CMS restores Affordable Care Act risk-adjustment transfers for 2017 benefit year

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released a final rule designed to allow and reissue payments under the Affordable Act risk-adjustment program to balance the insurance market. According to CMS Administrator Seema Verma, “This rule will restore operation of the risk adjustment program and mitigate some of the uncertainty caused by the New Mexico litigation.”  

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Proposed rule could provide an extra $10 billion for reinsurance

As Congress struggles to keep the federal government open, analysis continues surrounding how to help stabilize the Affordable Care Act (ACA). Oliver Wyman and the Congressional Budget Office (CBO) suggest that the federal reinsurance funds would reduce premiums for years to come.

A Cost sharing reduction (CSR) is a discount that is applied to the individual’s health insurance premium which lowers the amount the member must pay for deductibles, copayments, and coinsurance. “The proposal to fund the CSRs would lower federal spending enough to pay for the reinsurance program and leave about $2 billion extra” says Senate health committee Chairman Lamar Alexander.

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