Statement of ACAP CEO Margaret A. Murray on Proposed Marketplace Regulation

FOR IMMEDIATE RELEASE: February 16, 2017

FOR MORE INFORMATION: Jeff Van Ness, (202) 204-7515;


WASHINGTON – Margaret A. Murray, CEO of the Association for Community Affiliated Plans (ACAP), made the following statement on the proposed regulations promulgated yesterday by the Centers for Medicare & Medicaid Services (CMS) pertaining to Health Insurance Marketplaces:

“For the past few weeks, ACAP and its member Safety Net Health Plans have made the case to Members of Congress and the Administration that every effort must be made to assure stability in Marketplaces—stable coverage for the 12 million-plus people who go through Marketplaces to get their coverage, and a stable business climate for health plans that offer coverage.”

“Many of the provisions we see in the proposed regulation will improve the stability of the Marketplaces and we appreciate the Administration’s recognition of the need to improve the risk pool.

“Some aspects of the regulation will require thoughtful implementation, especially the provisions surrounding Special Enrollment Period verification. Young, healthy enrollees are critical to a balanced risk pool. If verification is overly burdensome, these young, healthy consumers may not complete their verification—leaving only the sickest and most motivated to follow through. Accordingly, the implementation of SEP verification and other reforms must be watched carefully.

“While these efforts to stabilize the market are laudable, the greatest source of immediate uncertainty for Safety Net Health Plans and others in the Marketplace remains the fate of cost-sharing reduction subsidy payments, which are the subject of a lawsuit brought by the House of Representatives. These payments, which are essentially a passthrough from health plans to consumers, totaled $4.9 billion in 2015.

“If cost-sharing reduction subsidy payments were to cease as a result of the lawsuit, Congress would have to move quickly to appropriate funds, or else insurers would be required to step in and fund them on their own. Their interruption would sow havoc in the Marketplaces, and their discontinuation would be an extinction-level event for many Qualified Health Plans.”

“ACAP and its member Safety Net Health Plans look forward to working with the Administration, CMS, and Members of Congress to improve stability in the Marketplace and assuring access to meaningful, high-quality health coverage.”

About ACAP
ACAP represents 59 nonprofit Safety Net Health Plans in 28 states, which collectively serve more than seventeen million people enrolled in Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), Marketplaces and other publicly-supported health programs.

For more information, visit

# # #