ACA Cost-Sharing Subsidies: How One Decision Could Disrupt Obamacare Marketplaces

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Premiums, insurer choice, and overall stability of 2018 Affordable Care Act (ACA) marketplaces could be affected by decisions from Congress and the Trump Administration on the health law’s cost-sharing reduction provision. With a legal appeal pending on a lawsuit from the U.S. House, the federal government and Congress are in a position to choose whether to continue reimbursing insurers for the subsidies, which were established as part of the ACA to reduce out-of-pocket costs for lower-income people buying plans through the marketplaces. Failure to continue the payments would not only disrupt the marketplaces, but it also might signal a more obstructionist approach to the ACA, following House Republicans’ failed attempt at repeal. Continuing the payments could help to avoid further exits and premium increases by insurers.

On Thursday, April 6, the Kaiser Family Foundation hosted a web briefing for the media to explain how the cost-sharing reduction program works, where it stands now, and how consumers could be affected by either choice from the federal government. Panelists presented new analysis on the magnitude of the cost-sharing payments and how much premiums would have to rise in different states to compensate for insurers’ loss of federal funding.

Panelists included Gary Claxton and Larry Levitt, co-executive directors of the Foundation’s Study of Health Reform and Private Insurance. Rakesh Singh, the Foundation’s vice president of communications, moderated the discussion.


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