Recent Court Ruling Could Help Preserve CSRs

Posted August, 3 2017 by Taylor Frazier

Gavel-CreativeCommonsWe have been talking a lot about the ACA Cost Sharing Reductions or CSRs in the last couple of months. CSRs are crucial subsidies that help make out of pocket health care costs, like deductibles and copayments, more affordable for people who earn incomes up to 250 percent of the Federal Poverty Level (about $61,000 for a family of four or $30,000 for an individual). CSRs are even more important in New York because they are a major source of funding for the Essential Plan, which provides low-cost insurance with no deductible and low copayments to more than 665,000 New Yorkers earning incomes under 200 percent FPL (about $49,000 for a family of four or $24,000 for an individual).

In 2014, the House of Representatives sued the Obama administration, alleging that the CSR payments were unconstitutional because the funds to pay for them were not appropriated by Congress. In 2016, a federal judge ruled in favor of the House, and the case is currently on appeal. U.S. Secretary of Health and Human Services, Tom Price, has not provided clarity on whether or not he will pursue the appeal, and President Trump has not provided consumers or insurance companies clarity on whether or not he will continue CSR payments in the meantime. An analysis from the Kaiser Family Foundation estimates that insurers would have to raise premiums nearly 20 percent to compensate for the loss of CSRs.

However, according to an article in the Washington Post, a federal appeals court issued a ruling earlier this week that could help keep the CSR payments in place. The U.S. Court of Appeals for the District of Columbia Circuit ruled that a coalition of 16 state attorneys general, including New York Attorney General, Eric Schneiderman, could intervene in the pending appeal and defend the CSR payments. As the article points out, this ruling could make it more difficult for President Trump and the House of Representatives to end CSRs without a fight in court.