Michael Marinaccio
Former Senior Digital Director


May 23, 2017


This week, House Republicans and the White House asked again for the federal appeals court for the DC circuit to continue a hold on litigation challenging the constitutionality of the payment of cost-sharing reductions (CSR) to health plans in the exchange’s individual market. This jointly filed request to delay the decision suggests a hesitation to terminate CSRs.

The joint status filing states, “the parties continue to discuss measures that would obviate the need for judicial determination of this appeal, including potential legislative action.” This may be an indication that the House and administration understand that stopping these payments would cause tremendous harm to millions of Americans, destabilize the already failing individual market, and increase premiums in 2018 by double digits. The Washington Postreports on the importance of CSRs:

The cost-sharing subsidies are one of two major types of assistance the law provides to most people who buy private health plans through the marketplaces. The cost-sharing subsidies, focused on lower-income ACA customers, reach nearly 6 in 10 such people. The other assistance helps cover insurance premiums for more than 8 in 10.

Consumers who buy their own insurance may soon be forced out of the market, whether through high premiums or by not having any coverage choices at all. With filing deadlines as soon as June, the U.S. Chamber sent a letter, urging action to guarantee consistent funding through 2018:

We urge Congress to take action now to guarantee a steady stream of CSR funding through 2018. Such action would represent a strong, positive step for all consumers who buy their own insurance by eliminating the single most destabilizing factor causing double-digit premium increases for 2018.

Millions of Americans do not receive health insurance through an employer, Medicare or Medicaid. The individual market is their only option for getting coverage. Unless CSRs are funded, a tremendous number of Americans will simply go without coverage and move to the ranks of the uninsured. This threatens not just their own health and financial stability, but also the economic stability of their communities.

Millions of Americans relying on the coverage offerings in the individual market shouldn’t lose their health plan or even worse face a very possible reality of having no health plan at all to enroll in for 2018. CSRs are an important stabilizing mechanism that must not be held hostage by political vitriol for prior legislative and administrative errors. Congress and the President must act soon to protect the individual market from collapsing. Failing to fund these CSRs will be more costly to taxpayers in the long run and is simply irresponsible, as the infographic below illustrates:

AHIP infographic: How Changes to Cost-Sharing Reductions Could Affect You

Source: America's Health Insurance Plans.

About the authors

Michael Marinaccio

Michael is the former Senior Digital Director at the U.S. Chamber of Commerce.