Trump’s Threats To End CSR Payments & End The Individual Mandate Have Caused Uncertainty For Insurers

WASHINGTON - One day after Connecticut's health insurers announced that costs will increase for Connecticut consumers by double digits, U.S. Senator Chris Murphy (D-Conn.) criticized the Trump administration during a U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee hearing on Thursday for threatening to end cost-sharing reduction (CSR) payments - which provide financial assistance to consumers for out-of-pocket costs - and roll back the individual mandate. Murphy, a member of the HELP Committee, argued that Trump's threats have caused confusion in the healthcare market place and premiums to rise. He called on his Senate colleagues to work to improve the cost and accessibility of health care for all Americans.

"Yesterday, in Connecticut, the new rates were announced for the two insurers who offer on our exchanges. There was an announcement of a 17 percent increase attributable only to the uncertainty around cost-sharing reduction payments, an additional six to eight percent increase due to the uncertainty around the individual mandate," said Murphy. "So, you're looking at a 20 percent increase to Connecticut consumers based only upon the uncertainty that this administration is inserting into the marketplace. It commands our attention."

Highlights of Murphy's remarks are below:

"Thank you very much, Mr. Chairman. Thank you all for being here.

"Yesterday, in Connecticut, the new rates were announced for the two insurers - Anthem included - who offer on our exchanges. There was an announcement of a 17 percent increase attributable only to the uncertainty around cost-sharing reduction payments, an additional six to eight percent increase due to the uncertainty around the individual mandate.

"So, you're looking at a 20 percent increase to Connecticut consumers based only upon the uncertainty that this administration is inserting into the marketplace. It commands our attention."

"I actually want to, essentially, re-ask the question that Senator Alexander asked because I think it is probably the most important question, especially as we try to sort through how we provide some more regulatory certainty to states.

"I think what Senator Alexander is saying is that because you have the ability under existing law to change these minimum benefits, we're searching for what the existing standard is. How a state would be guided in doing that today? What would be allowed and what wouldn't be allowed? And whether we need to amend that standard or clarify that standard because it's already permissible, but there's an uncertainty as to how you would be guided.

"And so, let me maybe ask this question to Dr. Turney, but I'll ask anybody to comment on it. If the standard is simple actuarial value of the overall benefit plan, then theoretically that would allow a state or a plan to get rid of let's say mental health benefits and maternity benefits, the things that young people use, so long as they load it up on hospitalization or on cardiac services.

"And I'd be interested as to what the upsides and downsides are of a model in which actuarial value is the simple measure of whether or not you can seek that kind of waiver, whether that's the right way or whether there's some peril to providers and to patients if you can essentially move around benefits at-will so long as, in the end, the amount of money that you're providing to an average beneficiary remains the same.

"I will stipulate that it's hard to figure out what the measurement would be other than actuarial value, but therein lies the problem. If it is, then you potentially provide some significant gaps and you get rid of the certainty of product that was part of the reason that we put it in so that when you bought insurance, you knew what it is.

But I think this is a true conundrum. If it's not actuarial value, then it's kind of hard to figure out what the substitute standard is."

Read this original document at: https://www.murphy.senate.gov/newsroom/press-releases/murphy-criticizes-trump-administration-for-uncertainty-in-connecticut-health-care-exchange-double-digit-rate-increases