Letter to Tom Price, Secretary of Health and Human Services - Cost-Sharing Reductions and the Affordable Care Act

Letter

Dear Secretary Price,

We write with immediate concerns regarding statements and actions made by the Trump Administration about the continued payment of critical cost-sharing reductions (CSRs). These statements have caused deep uncertainty for insurers and the American public, resulting in proposed premium increases that are far higher than necessary. We request firm and immediate assurances that CSRs to insurers will continue uninterrupted at least through the end of 2018. Providing this necessary certainty will protect consumers from needless premium hikes and give insurers the information they need to continue offering Marketplace plans. Failure to do so will increase costs, decrease consumer choice, and irreparably damage the individual insurance market.

The Affordable Care Act (ACA), by nearly all measures, has been a success. Millions of Americans have access to health insurance for the first time and new protections guarantee that the most vulnerable among us will not be denied coverage or bankrupted because of a medical condition. While we continue to work in good faith to address the shortcomings of the ACA, it goes without saying that the law has moved us towards a dramatically more equitable and accessible health care system, saving countless lives along the way.

This is why the continued efforts by the Trump administration to sabotage the ACA for political reasons are dangerous and costly, with the American people ultimately bearing the full brunt of these reckless and ill-advised attempts. Each month, the Administration plays chicken with the payment of CSRs, in what is seemingly a purposeful attempt to sow instability in the ACA marketplaces. In fact, some insurers have already factored the uncertainty on cost-sharing reduction payments into their plans for 2018.

An analysis recently released by the Kaiser Family Foundation lays this out bluntly, finding that "[s]ome insurers explicitly factor this uncertainty into their initial premium requests, while other companies say if they do not receive more clarity or if cost-sharing payments stop, they plan to either refile with higher premiums or withdraw from the market." This is true in Connecticut, and if premiums do increase and insurers flee the market, the needless uncertainty created by the Trump administration will be to blame. Worse yet, if the Trump administration does discontinue CSR payments, the nonpartisan Congressional Budget Office (CBO) estimates that more Americans will live in a place where no insurers offer a nongroup plan, the federal deficit would increase by billions, and premiums would rise by 20 percent next year alone.

As Connecticut works to finalize rates for next year and insurers make decisions on whether or not to remain on Connecticut's exchange, it is essential that the Trump administration stop playing political games with the affordability and stability of our health insurance market. We urge you to immediately and permanently fund cost-sharing reductions at least through the end of 2018 so insurers in Connecticut and around the country have the certainty they need to operate effectively on ACA exchanges. Due to the urgency of this situation, we request a response regarding cost-sharing reduction payments by September 1, 2017.