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Congress holds trump card on exchange cost sharing reduction subsidies (pun intended)

April 13th, 2017

In the coming weeks, the Trump administration will need to say clearly whether they plan to fund cost-sharing reductions ā€” payments that reimburse insurers for providing discounted deductibles to low-income ObamaCare enrollees. In an interview with The Wall Street Journal Wednesday, Trump said he was considering withholding the payments to force Democrats to work with him on healthcare.

Source: Trump faces risky ObamaCare choice | TheHill

Actually Congress — and not the Trump administration — holds far more power to resolve the outstanding issue of funding for cost sharing reduction subsidies for plans sold on state health benefit exchanges that’s giving non-group health plan issuers heartburn as they prepare for plan year 2018.

First because the House of Representatives brought the underlying litigation over the constitutionality of the Obama administration’s funding of the subsidies. It as petitioner — and not the executive branch as respondent — can make the litigation go away by dropping it. A federal district court that decided the case in favor of the House last May put its ruling on hold, giving the House the option to drop the case.

Second because Congress holds the power of the purse. It ultimately decides whether funds for the subsidies are appropriated, not the administration.

 


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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