President’s plan to end cost sharing payments would cost CT plans $7 million this year

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An analysis by Avalere Health estimates that health plans in CT’s insurance exchange, Access Health CT, would lose $7 million in reimbursements this year unless Congress acts to restore payments. Nationally, plans stand to lose over $1 billion this year. Under the Affordable Care Act, low to moderate income Americans purchasing exchange coverage are protected from excessive premium and cost sharing payments to health plans. However, whether the federal government is required to reimburse health plans for those costs has been disputed in court. While plans can roll the lack of reimbursements into premiums for next year, because 2017 health plans contracts are already set, they cannot adjust premiums for this year. Despite the ongoing legal challenge, the federal government has consistently made those reimbursement payments every month for over three years. Last week President Trump announced he intends to end those reimbursements to health plans. Earlier this year, the Congressional Budget Office estimated that ending those reimbursements would result in more uninsured next year and actually increase the federal deficit by $194 billion through 2026 due to sharply higher insurance premiums. A Senate deal to restore the payments is moving through the process.