Fund CSR payments for no fewer than 2 years, healthcare trade groups urge Senate

Document titled, Affordable Care Act
AHIP and other healthcare trade groups argue that committing to CSR funding for two years “would go a long way to bring much needed stability to the individual market and promote access to more affordable coverage and choices for millions of Americans.” (Getty/Designer491)

Some of the most powerful healthcare industry groups have come together to send a strong message to the Senate: One year of guaranteed funding for cost-sharing reduction payments isn’t enough.

In a letter (PDF) sent to the Senate Health, Education, Labor and Pensions (HELP) committee on Tuesday, the groups urged lawmakers to craft legislation that funds the subsidies for at least two years—from 2018 through 2019. 

“Without two years of CSR funding, uncertainty will persist and the Congress will need to address these same issues early next year,” it states. 

The letter was signed by America’s Health Insurance Plans, the American Academy of Family Physicians, the American Benefits Council, the American Hospital Association, the American Medical Association, the Blue Cross Blue Shield Association, the Federation of American Hospitals and the U.S. Chamber of Commerce.

Senate HELP Committee Chairman Lamar Alexander, R-Tenn., recently told Politico that he envisions crafting a narrow bill that includes just one year of funding for CSR payments, which insurers receive and then pass on to individual market consumers to mitigate their out-of-pocket healthcare costs. 

But Democratic Sen. Patty Murray, the committee’s ranking member, told the publication she believes two years would be preferable.

AHIP and the other trade groups back up that point, arguing that committing to CSR funding for two years “would go a long way to bring much needed stability to the individual market and promote access to more affordable coverage and choices for millions of Americans.” 

In addition, they note that if there isn’t a break in CSR funding, “we expect that this provision would not contribute to the federal deficit.”

The fate of the CSR program has been in flux since President Donald Trump took office, as he has only agreed to fund them one month at a time and has repeatedly threatened to end the payments. 

Driving the uncertainty is the fact that the CSR program is at the center of a federal court case, in which House Republicans have argued the payments are illegal because Congress never appropriated them. A judge previously ruled in the plaintiffs’ favor, and the Obama administration appealed, but under Trump the case has been on hold.

The court recently gave ACA supporters a win, though, when it ruled that 16 Democratic attorneys general can intervene in the case—allowing them to keep the appeal alive and thus make it more difficult for Trump to unilaterally end the payments.

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