A report released Thursday by the health care consulting firm Avalere dives into the impact of President Donald Trump’s move Friday to cut off cost-sharing reduction (CSR) payments to health insurance companies weeks before the start of the crucial open enrollment period.
Because the companies are obligated by law to lower the cost of coverage for low-income patients with severe health needs, and can’t raise their rates until next year, Avalere calculates that the insurers will have to eat a $1 billion loss between now and January.
“Health plans are stuck because they are required to keep selling more generous plans without the federal funding that pays for the cost of those enhanced benefits,” Avalere’s Chris Sloan explained.
His colleague Caroline Pearson added: “While many states and insurers had prepared for the possibility that CSR funding would be cut off in 2018, the immediate failure to pay subsidies leaves plans with no way out for 2017. Plans can neither increase premiums nor exit the market at this late stage.”
The states hardest hit by the cut, the report found, are a mix of Democratic, Republican and swing states. The largest projected losses will occur in Florida (-$200M), California (-$107M), Texas (-$98M), North Carolina (-$66M), Georgia (-$56M), and Virginia (-$34M).
In 2018, insurers will pass on that cost to the government—as Obamacare’s tax credits increase to meet the need of subsidized plans—and middle class patients who don’t qualify for subsidies. Already, many states are reporting large premium hikes specifically attributed to Trump’s CSR cut.