In what could be good news for nervous health insurers, some Republicans acknowledge that they may have no choice but to temporarily fund cost-sharing reductions as they work on an Affordable Care Act replacement.
Depending on how Donald Trump’s administration decides to handle the House v. Burwell case—which challenges the legality of funds appropriated to insurers to lessen consumers’ out-of-pocket costs—CSRs could end abruptly. The case is currently on hold, and the parties have until Feb. 21 to decide how to proceed.
Experts have warned that ending CSRs spell disaster for the public exchanges. Indeed, America’s Health Insurance Plans CEO Marilyn Tavenner has said that insurers will “pull out of the market during the next logical opportunity” if they learn subsidy payments won’t continue.
Recognizing that could imperil the smooth transition away from the ACA that Republicans have promised, some in the party are calling for continuing the payments, according to Politico.
House Energy and Commerce Chairman Greg Walden, for example, told the publication that because health plans have the ability to cancel midyear if CSRs aren’t funded, he wants to make sure Republicans don't "pull the rug out" from under consumers. Utah Gov. Gary Herbert also has urged Congress to fund the subsidies until the end of the year.
Yet Rep. Tom Cole, R-Okla., who chairs the House Labor and Health and Human Services appropriations subcommittee, isn’t convinced. “I don’t know that we're particularly obligated to pay for the mistakes that the Obama administration made that violated the law,” he told Politico.
Choosing to prop up CSRs is indeed politically risky for Republicans, as they have long slammed them as “bailouts” to insurers. One possible solution to that quandary would be to issue funding directly to consumers rather than to insurers, according to the article, though the GOP has not yet made a final decision on how to proceed.
As for Republicans’ plans to replace the law, President-elect Donald Trump told The Washington Post that he is close to revealing a plan that would feature “insurance for everybody.” He also said he wants to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid, but did not offer any further policy details.