The President announced that the government would stop paying cost-sharing subsidies immediately. The future of cost sharing reductions (CSRs) has been murky, as detailed back in August. Unless Congress intervenes and strikes a bipartisan deal to extend the CSRs – and soon – the result will be a national average 20% premium increase for Exchange plans and a subsequent nearly $200 billion blow to the federal deficit.

Nothing changes for consumers in 2017, but some Exchange enrollees will experience sticker shock when they go to enroll on WA Healthplanfinder for 2018. When open enrollment begins November 1, they’ll find that insurers are charging more for some plans to make up for lost subsidy funds; the premiums for silver plans will increase an average of 22%. Insurance Commissioner Kreidler calls this the ‘Trump Tax’ – “essentially a tax President Trump is imposing on consumers.” Premium subsidies will offset the increase for enrollees with income below 400% of the poverty level. Those who are ineligible for premium subsidies may avoid the large increase by choosing other levels of coverage (bronze or gold plans), seek non-Exchange coverage, or go without coverage. These choices will be tricky and complicated. Insurers may ultimately decide to exit an unstable market. Washington Attorney General Bob Ferguson joined 18 other states and the District of Columbia in a lawsuit asserting the decision is illegal and unconstitutional.

Perhaps Senator Chris Murphy (D-CT) said it best, “the President is setting our entire health care system on fire.”

Senators Patty Murray and Lamar Alexander announced a bipartisan deal earlier this week to fund the CSRs through 2019, increase funding for outreach and enrollment activities, and streamline the waiver process while maintaining core provisions. More to come as we wait to see if the Senate and the House will go along with this deal. It ain’t over yet…