Two-year commitment needed for CSR stability

At least two years of continuous funding for cost-sharing reduction (CSR) benefits is necessary to stabilize and strengthen the individual health insurance marketplace, according to a coalition of health care and health insurance providers. In a letter to the chair and ranking member of the Senate Committee on Health, Education, Labor, and Pensions, a group including America’s Health Insurance Plans, the American Hospital Association, the American Academy of Family Physicians, the American Medical Association, BlueCross BlueShield Association, the American Benefits Council, and the U.S. Chamber of Commerce requested a firm commitment to CSR payments.

Under Section 1402 of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), many individuals enrolling in qualified health plans through the marketplace are eligible for reduced cost sharing based on income. These reductions are guaranteed by the ACA; the federal government is supposed to make CSR payments to insurers offering plans in the marketplace to cover the reduced prices paid by plan enrollees, but the law does not guarantee those payments. The Trump Administration has not yet committed to continuing to make the payments.

In the letter, the providers and insurers explained that nearly 60 percent of enrollees in qualified health plans have CSR benefits, but noted their concern about uncertainty about CSR payment funding. They requested two full years’ funding for the CSR program, and warned that without that certainty, premiums will increase and fewer insurers will participate in the marketplace.