Though the Trump administration has agreed to temporarily fund cost-sharing reduction payments, some groups—including health insurers—aren’t particularly impressed.
The agreement was reached after House Minority Leader Nancy Pelosi and Office of Management and Budget Director Mick Mulvaney sparred over the subsidies during a Tuesday evening phone call, Politico reported.
“Although a final decision for how long has not yet been made, the administration will continue to pay CSRs,” a White House budget official confirmed in a written statement, according to The Wall Street Journal.
Indecision over whether to appropriate funding for CSRs, which are crucial to keep the Affordable Care Act marketplaces afloat, had threatened Congress’ push to agree on a spending bill needed to avoid a government shutdown. The subsidies are the subject of a pending court case, in which House Republicans argued they are unconstitutional because Congress never appropriated funds for them.
The Trump administration previously said that it would continue funding CSRs until that case—which is on hold during the appeals phase—is resolved. But healthcare groups have said that isn’t enough to remove the uncertainty that is complicating insurers’ decisions about what plans to offer in the ACA exchanges next year and how to price them.
It seems that the latest development does little to assuage those concerns.
“We continue to need clarity,” Kristine Grow, a spokeswoman for America’s Health Insurance Plans, wrote in an email to FierceHealthcare, noting that the trade group wants Congress to fund the subsidies. “Seven million Americans depend on cost-sharing reduction subsidies to make their coverage and care more affordable,” she added.
Some Republicans are also not thrilled with the Trump administration’s decision, given that it could weaken the House’s case in the pending lawsuit.
Rep. Mark Walker, R-N.C., chairman of the Republican Study Committee, said in a statement to Politico that it is “clearly illegal and unconstitutional” for the Trump administration to fund CSRs without approval from Congress.
On Wednesday, Anthem CEO Joseph Swedish offered his own take on the CSR funding battle, noting that if those subsidies disappear, the insurer might change its product offerings, raise rates or exit some markets entirely.
If Anthem chose to exit all of the states in which it currently sells ACA exchange plans, nearly 250,000 additional customers would be left without marketplace options next year, according to Bloomberg.
Humana’s decision to exit the exchanges has already left six Tennessee counties—where 46,214 customers selected plans this year—without a single on-exchange option next year, the article added.