The health-care industry is asking for a two-year commitment of funds from the U.S. Senate’s health committee as a bipartisan group of legislators begins work Wednesday and Thursday to fix the individual insurance market under the Affordable Care Act.
Lobbies for health insurance companies, doctors and big business are asking the Senate Committee on Health, Education, Labor and Pensions to provide more stability than the Donald Trump White House, which has paid for cost-sharing reductions (CSRs) on a month-to-month basis.
Without CSRs, Obamacare customers face cost increases of 20%-25% or more, insurers say . And hospitals have said they expect unpaid bills to begin piling up faster than they already are.
“We urge the committee to include continuous funding for CSR benefits for at least the next two years (2018-2019) as part of bipartisan legislation to stabilize the individual market,” the health-care lobbies, led by America’s Health Insurance Plans, wrote to Sens. Lamar Alexander (R-Tennessee) and Patty Murray (D-Washington) in a letter issued Tuesday. “Without two years of CSR funding, uncertainty will persist, and the Congress will need to address these same issues early next year.”
The lack of a commitment on CSRs has led some insurers like Anthem and Molina Healthcare to scale back their individual offerings in certain states under the ACA. Aetna, UnitedHealth Group and Humana have also complained of an unstable individual insurance market in deciding to pull individual products off the exchange after being unable to successfully manage health costs of sick patients who had bought Obamacare policies.
Trump committed to funding CSRs for August but not beyond that, despite intensifying pressure from the health-care industry. But neither Trump or Health and Human Services Secretary Tom Price have offered a long-term commitment to CSRs.
Without CSRs, there will be an average increase in premiums for “benchmark silver plans by 20 percent in 2018 and by 25 percent in 2020,” the lobbies said. The others that signed the letter to Senators Alexander and Murray were the American Academy of Family Physicians, the American Benefits Council, the American Hospital Association, the American Medical Association, the Blue Cross Blue Shield Association, the Federation of American Hospitals and the U.S. Chamber of Commerce.
“CSR benefits help those who need it most: low- and moderate-income Americans with incomes under 250 percent of the federal poverty level,” the industry’s letter says. “Nearly 60 percent of exchange-plan enrollees rely on CSR benefits, which translates into comprehensive coverage and access for nearly six million individuals and families. The CSR program makes it more affordable for patients to receive needed medical care and services by reducing deductibles, co-payments and out-of-pocket maximums.”