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


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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:

“ACAP-member Safety Net Health Plans agree with CMS that improving the risk pools in Marketplace can and should be a top priority.

“We are appreciative of many of the changes laid out in the new regulation, but have some concerns around their implementation.

“However, these concerns pale in comparison to the issue of cost-sharing reduction reimbursements. Leaders in Congress and the Administration have chosen to leave the question of CSRs open. And it means that insurers who operate in Marketplaces must account for not only actuarial risk, but also political risk. This risk was made explicit last week by President Trump.

“These payments totaled $4.9 billion in 2015, and estimates for 2017 and beyond are higher still. CMS acknowledges that these new regulations will result in higher out-of-pocket expenses for consumers, and result in an additional $400 million in cost-sharing reductions for consumers with low incomes.

“Insurers are putting together proposals right now for participation in the Marketplaces in 2018. So long as CSRs remain a political football, health plans will raise rates—by as much as 20 percent or more—to account for that uncertainty, or they may withdraw from the market to avoid this risk.

“This is an issue that can be simply resolved through an appropriation, notwithstanding House v. Price. Congress and the Administration should do the right thing and act to put this issue to rest. Then plans participating in Marketplaces could get back to doing what they do best: provide top-notch coverage.

“ACAP and its member Safety Net Health Plans look forward to working with the Administration, CMS, and Members of Congress to achieving that goal.”

About ACAP
ACAP represents 60 nonprofit Safety Net Health Plans in 29 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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