Lack of action by the federal government to guarantee cost-sharing reduction payments through 2018 is undermining the individual market to the extent that several insurers have left the marketplace, premiums may rise by 60 percent, and millions will go without coverage, provider and payer organizations wrote to Senate leaders on Friday.
"There now is clear evidence that this uncertainty is undermining the individual insurance market for 2018 and stands to negatively impact millions of people," they said. "Simply put, continued uncertainty, particularly the lack of clarity around CSR payments, has led several insurers to conclude that they cannot participate for 2018. Those who will participate are responding to the market uncertainty with premium requests that are as much as 60 percent higher than last year."
The letter by America's Health Insurance Plans, the American Hospital Association and other organizations urges Senate leadership to take action to guarantee a steady stream of cost-sharing reduction funding through 2018.
"Such action would represent a strong, positive step for all consumers who buy their own insurance by eliminating the single most destabilizing factor causing double-digit premium increases for 2018," the letter said.
It went to Majority Leader Mitch McConnell, Democratic Leader Chuck Schumer, Majority Whip John Cornyn and Minority Whip Dick Durbin.
Signing on were America's Health Insurance Plans, American Academy of Family Physicians, American Benefits Council, American Hospital Association, American Medical Association, Blue Cross Blue Shield Association, Federation of American Hospitals, and the U.S. Chamber of Commerce.
This is at least the second letter from provider and payer organizations urging for the funding of CSRs that was included in the Affordable Care Act but is now in jeopardy.
The funding is not included in the Republican American Health Care Act and a federal court ruled against the continued CSR payments. President Obama appealed the case which is now on hold awaiting a status update on Monday.
The Senate is working on legislation that includes provisions intended to promote short-term stability in the individual market, the letter said.
"However, in light of 2018 filing deadlines, most of which fall on or before the June 21 deadline for federally facilitated marketplaces, health plans have only a few more weeks to decide whether and how to participate in this market," it said. "In several states, the deadline to file products and initial rates has already passed."
Earlier this week, the National Association of Insurance Commissioners expressed its concerns about CSR uncertainty to Congressional leaders.
"Taxpayers will pay billions of extra dollars in costs due to higher premium subsidies--in fact, recent studies have found overall federal costs will be 23 percent higher," the letter said.