Florida insurance regulators ask payers to file backup rates in case Trump administration withholds CSRs

Health insurance, pen and stethoscope
Florida regulators have asked payers to provide backup plans in case CSRs are not funded. (Getty/Minerva Studio)

Uncertainty over the Trump administration’s plans for cost-sharing reduction payments has payers on edge as they file their individual market rates for 2018. And in one state, regulators have asked insurers to file back-up plans.

The Florida Office of Insurance Regulation asked the nine payers that participate in the state exchanges to file rates in case the CSR payments don’t come through, the agency told FierceHealthcare. The average rate increase was already 17.8% for 2018, according to reported (PDF) from FOIR. With CSR payments out of the picture, rates are more than likely to jump. 

Blue Cross Blue Shield of Florida, the state’s largest insurer, is projecting increases of about 20% if the Trump White House does not fund CSRs, according to its filings. Darnell Smith, the payer’s market president for North Florida, said in a July interview with the Jacksonville Daily Record that it would likely make insurance unaffordable for some of its members.

“If those go away, the coverage that we provide could become unaffordable for quite a few folks,” Smith said.

RELATED: Refusing to accept defeat on ACA repeal, Trump poised to decide fate of CSR payments

The fate of the CSR payments rests at least in part in President Donald Trump’s hands. Experts have named continued funding for those payments as key to stabilizing the individual insurance markets.

A court ruling earlier this week, though, may have made a notable dent in Trump’s power to use CSRs as a health reform bargaining chip. A U.S. appeals court ruled that states can intervene in Congress’ ongoing suit against the payments.

The uncertainty about CSRs is reflected in rate filings beyond Florida as well. Median premiums in New Hampshire could rise 43% based on state filings (PDF) and significant increases are also expected in states like Wyoming (PDF). Molina Healthcare, which posted significant losses in its second quarter, could hike its Affordable Care Act plan rates by as much as 55%.

America’s Health Insurance Plans spokeswoman Kristine Grow told FierceHealthcare that payers are in desperate need of certainty when planning for 2018 and beyond.

“As plans make decisions for 2018, they do so with a view of wanting to serve consumers in the market for the full year,” she said. “That's why it's so important to know what will happen with CSRs long term.”

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