Trump administration's statement on CSR funding not enough to reassure AHIP

The Department of Health and Human Services is still engaged in a legal case with House Republicans over the legality of funding for a type of ACA subsidy.

Though the Trump administration said that it will continue funding cost-sharing reduction (CSR) payments while a lawsuit surrounding them plays out, the health insurance industry’s major trade group isn’t celebrating just yet.

The government pays CSRs to insurance companies so they can subsidize the out-of-pocket healthcare costs of low-income Affordable Care Act exchange customers. These subsidies have been at the center of a lawsuit in which House Republicans claimed Congress never appropriated the billions of dollars to fund them.

Since President Donald Trump took office, the case has been on hold as his administration decided how to handle the Obama administration’s appeal of a judge’s ruling that favored the plaintiffs.

In a statement sent Monday to The New York Times, the Department of Health and Human Services wrote: "The precedent is that while the lawsuit is being litigated, the cost-sharing subsidies will be funded. It would be fair for you to report that there has been no policy change in the current administration."

Yet in an email to FierceHealthcare, America’s Health Insurance Plans spokeswoman Kristine Grow indicated that isn’t enough.

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

Similarly, while Ceci Connolly, president and CEO of the Alliance of Community Health Plans, is "encouraged" by the Trump administration's statement, she wrote in an email that "our nonprofit plans are eager to hear a commitment for 2018 and beyond so that those families have peace of mind and we can get back to the business of delivering great healthcare."

Indeed, health insurance trade groups have implored the Trump administration and Republican lawmakers to offer them more clarity about what will happen to CSRs funding, as the marketplaces would likely collapse without it. Speaker Paul Ryan had said the House won’t drop the lawsuit, but indicated he expected CSRs would be funded while the case is litigated.

Trump advisers, however, reportedly were divided on how to handle the subsidies, so Monday’s statement from HHS is a slightly clearer indication of what the administration plans to do.

But as AHIP’s Grow pointed out, the statement only promised funding for CSRs while the lawsuit against them is ongoing. That leaves the fate of funding for the subsidies up in the air after the legal case is resolved, which could happen before the 2018 benefit year is over.

Editor's note: This article has been updated to add a statement from the Alliance of Community Health Plans.