6 healthcare organizations react to the end of cost-sharing subsidies

President Donald Trump announced late Thursday that his administration would immediately end cost-sharing reduction subsidies to payers.

The cost-sharing reductions help offset the cost of providing health insurance to low-income Americans on the exchanges.

Here are six healthcare organizations' reactions to the announcement.

Alliance of Community Health Plans: ACHP's President and CEO Ceci Connolly said the organization is "deeply disappointed in the Administration's actions this week to undermine access to affordable coverage for millions of Americans … CSRs have been a bargaining chip for too long."

America's Health Insurance Plans and Blue Cross Blue Shield Association: The health insurance giants co-authored their reaction to the decision, with both anticipating widespread consequences.

"These payments are not a bailout — they are passed from the federal government through health plans to medical providers to help lower costs for patients who see a doctor to treat their cancer or fill a prescription for a life-saving medication," they wrote. "This action will make it harder for patients to access the care they need. Costs will go up and choices will be restricted."

American Medical Association: David O. Barbe, MD, president of the AMA said the cost of insurance would rise sharply without the subsidies.

"The AMA is deeply discouraged by the administration's decision last night to end the cost sharing reduction (CSR) payments to insurers, which are used to reduce deductibles and co-payments for low-income enrollees in the marketplace plans created under the Affordable Care Act (ACA). Republicans and Democrats alike have expressed concern about the affordability of healthcare coverage under the ACA, and bipartisan efforts have been underway in Congress to provide the specific authorization and funding for CSR payments to address the legal issues involved. This most recent action by the administration creates still more uncertainty in the ACA marketplace just as the abbreviated open enrollment period is about to begin, further undermining the law and threatening access to meaningful health insurance coverage for millions of Americans. Our patients will ultimately pay the price. We urge Congress to accelerate its efforts to reinstate these payments before further damage is done."

Association for Community Affiliated Plans: Margaret Murray, CEO of ACAP, said the decision to cancel subsidies will not have the effect on insurance markets that the Trump administration intends.

"This decision will lead to less competition, fewer choices for consumers and higher costs for all of us, regardless of where we get our health insurance. The payments ceased by the Trump administration reimburse health plans, who cover the costs of deductibles and copays for their members who qualify for cost-sharing reductions through marketplace plans owing to low incomes. More than half of all marketplace consumers benefit from such subsidies, which totaled $4.9 billion in 2015. These subsidies are estimated to be up to $7 billion this year, or about 15 percent of premium. For the rest of 2017, insurers are required to fund cost sharing reductions on their own. Some plans will find their continued presence in the marketplaces beyond this year to be an unsustainable proposition, and will likely leave the market."

Council for Affordable Health Coverage: Joel White, president of the CAHC, said that while his organization does not support the ACA, as long as it remains law, cost-sharing subsidies are essential for stable insurance markets.

"The Council for Affordable Health Coverage has leveled frequent criticisms against the ACA, but we have also consistently acknowledged that millions rely on coverage in the current market and should not have the rug pulled out from underneath them. If the Trump Administration ends critical cost-sharing reduction payments, it is imperative that Congress acts immediately to fund this lifeline for vulnerable Americans. To do otherwise would put coverage at risk for millions and would only compound the uncertainty that permeates the healthcare marketplace today. Congress and the administration have every right to continue their efforts on health care, but they must act responsibly; ensuring that, when all is said and done, there is an individual market left to reform. This means working in a bipartisan fashion to provide Congressional authorization for CSR payments until such time as Congress can deliver a more workable, market-based alternative. We further support the ongoing efforts of the Senate HELP Committee to deliver greater flexibility to states through the ACA's 1332 waiver program. The shortcomings of [the ACA] must be met with solutions instead of sabotage and we look forward to working with policymakers to deliver exactly that."

Federation of American Hospitals: Chip Kahn, president and CEO of the FAH, says the subsidies are essential for affordable insurance coverage.

"Millions of working Americans families depend on the subsidization of their cost sharing to ensure them access to the health care they need. Unfortunately, a decision has been made to stop Federal payments for the cost sharing. This action will jeopardize the health care coverage on which so many Americans depend. It is critically important that the Congress act with dispatch to ensure the Federal funds remain available to pay for the cost sharing for those working American families."

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