Government Files Response In Cost-Sharing Reduction Payments Suit, Lays Out Tough Standards For Iowa Waiver

On October 20, 2017, the federal government filed a response to the states’ motion for a temporary restraining order and injunction in California v. Trump. The attorneys general of eighteen states and the District of Columbia sued the federal government on October 13 challenging as illegal President Trump’s decision to cease cost-sharing reduction (CSR) payments; these payments reimburse insurers for the reductions in out-of-pocket limits, deductibles, and other cost-sharing that the insurers are legally required to offer low-income enrollees in silver marketplace plans. On October 18, the states moved for a temporary restraining order and preliminary injunction to keep the payments flowing. The Government’s Argument The basic contention of the government’s brief is the argument that the House of Representatives made successfully to the federal district court in its lawsuit against the Obama administration—that the cost-sharing reduction requirements of the ACA are separate from its premium tax credit provisions and that, while the ACA appropriated funding for the premium tax credits through the tax refund provision of the Internal Revenue Code, Congress has never appropriated funding for the CSR payments. Since Congress has never appropriated funding for the CSR payments, the government cannot reimburse the insurers for reducing cost sharing, and the court cannot order it to do so. Until its recent change of position in the House litigation, the government argu...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage 1332 waivers cost-sharing reduction payments Source Type: blogs