An analysis by Avalere
Health estimates that health plans in CT’s insurance exchange, Access
Health CT, would lose $7 million in reimbursements this year unless Congress
acts to restore payments. Nationally, plans stand to lose over $1 billion this
year. Under the Affordable Care Act, low to moderate income Americans purchasing
exchange coverage are protected from excessive premium and cost sharing payments
to health plans. However, whether the federal government is required to
reimburse health plans for those costs has been disputed in court. While plans
can roll the lack of reimbursements into premiums for next year, because 2017 health
plans contracts are already set, they cannot adjust premiums for this year. Despite
the ongoing legal challenge, the federal government has consistently made those
reimbursement payments every month for over three years. Last week President
Trump announced he intends to end those reimbursements to health plans. Earlier
this year, the Congressional
Budget Office estimated that ending those reimbursements would result in
more uninsured next year and actually increase the federal deficit by $194
billion through 2026 due to sharply higher insurance premiums. A Senate
deal to restore the payments is moving through the process.
