Statement of ACAP CEO Margaret A. Murray on Need for Continuation of CSRs

FOR IMMEDIATE RELEASE: April 5, 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 need for continuation of cost-sharing reduction subsidy payments for health plans operating in Health Insurance Marketplaces:

“Safety Net Health Plans have deep concerns with the continuing mixed signals coming forward from this Congress with respect to the future of cost-sharing reduction subsidy payments to health plans.”

“These payments are essentially a passthrough from health plans to consumers who qualify for cost-sharing reductions through Marketplace plans owing to low incomes. More than 85 percent of Marketplace consumers benefited from such subsidies, which a joint ACAP-Milliman study found to total $4.9 billion in 2015 and represent nearly eight percent of earned Marketplace premium for all insurers.

“Without these subsidy payments, insurers would be required to fund them on their own. Few health plans could sustain unplanned expenses of such magnitude; many would be forced to exit the market if CSR payments were discontinued for an extended period of time; those that remain for Plan Year 2018 would be forced to raise their premiums substantially. To give a sense of scope, insurers built their rates for 2017 working under the estimation that just over $7 billion in cost-sharing reduction expenses would be reimbursed by the government.

“This uncertainty is a toxic business environment for health insurance plans, and can prove costly to health plans and consumers alike. This issue could readily be resolved with an act of Congress. Its allowance to linger is a choice, and a puzzling one.

“Like Members of Congress have mentioned in the health care debate, a stable business environment is desirable for all participants. We look forward to working with Congress and the Administration to promote such an environment now, and perform a cost-sharing reduction appropriation as soon as possible. The continuing resolution under consideration would be an appropriate vehicle to set this issue to rest.”

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.

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