Patients Pay for Ending Cost-sharing Reduction Payments
Federal cost-sharing reductions (CSR) payments, which helped lower
health insurance deductibles and co-payments for millions of low-income
Americans obtaining coverage in the Affordable Care Act (ACA)
marketplace, will be discontinued this month, the Department of Health
and Human Services (HHS) announced Oct. 12.
[from the AMA Advocacy Update]
The move followed the White House's statement that referred to CSRs
as "unlawful payments" and a "bailout of insurance companies" that were
being funded without a Congressional appropriation. AMA President David O. Barbe, MD, MHA, said the AMA "is deeply
discouraged" by the president's decision because it "creates more
uncertainty" in the individual insurance marketplace and threatens
"access to meaningful health insurance coverage for millions of
Americans" just as an abbreviated open-enrollment period is about to
"Republicans and Democrats alike have expressed concern about the
affordability of health care coverage under the Affordable Care Act,
and bipartisan efforts have been underway in Congress to provide the
specific authorization and funding for CSR payments to address the legal
issues involved," Dr. Barbe (@DBarbe_MD)
said. "Our patients will ultimately pay the price. We urge Congress to
accelerate its efforts to reinstate these payments before further
damage is done."
It is estimated that at least 6 million people had their costs of
care lowered by a CSR, at an annual cost to the federal government of
around $7 billion.
The AMA joined a coalition of organizations representing family physicians, hospitals, health insurers and employers in urging Congressional
leaders to "take action now to fund" CSR benefits. The joint letter
notes the Congressional Budget Office's determination that ending the
funding that supports CSR benefits will:
Bipartisan efforts in the Senate, led by Health, Education, Labor and
Pensions Committee Chair Lamar Alexander, R-Tenn., and Ranking Member
Patty Murray, D-Wash., have produced an agreement to restore the CSRs.
The legislative pathway for Congressional approval, however, remains
- Drive up premiums, increasing average premiums for benchmark
silver plans—the most popular plans on the exchanges—by 20 percent in
2018, and by 25 percent in 2020.
- Deny choices for consumers and greatly increase the risk that some places will have no coverage options at all.
- Increase the federal budget deficit by $194 billion over the next 10 years.