August 2017

While Congressional efforts to dismantle the ACA appear to have stalled, there is still much legislative and administrative uncertainty surrounding it– particularly federal subsidy payments made to individuals who purchase health insurance on the private market. As you may recall, the ACA provided federal subsidy premium and copay support for low and middle income families who purchased private insurance. President Trump has threatened to halt the ACA's cost sharing reduction (CSR) payments to insurers, which if carried out, would cause significant disruption in the individual market, including steep premium increases and the departure of more insurance companies from the state insurance exchanges. The House Republicans have sued the Department of Health and Human Services, claiming that Congress did not appropriate funds for subsidy payment and therefore any subsidy payments made by HHS are illegal. A lower court has agreed with the House Republican suit, but stayed that decision pending appeals. Most recently, the court granted several states "intervener status" allowing these states to defend the legitimacy of the federal subsidy payments.