Statement on Cost-Sharing Reduction Payments

Partners is opposed to the Administration’s announcement that it will cease making Cost-Sharing Reduction (CSR) payments. Insurer subsidy payments, also known as cost-sharing reductions, are critical for low-income patients who rely them to offset copays and deductibles. These payments make coverage accessible for many patients and families who otherwise could not afford health insurance or care. Discontinuing payments will also effect moderate-income Americans in the individual market who will be faced with even higher premiums. This latest action works against one of the most challenging and persistent problems facing patients: predictable, manageable out-of-pocket costs, and limited cost shifting.

Partners focus is based on research coupled with membership expertise and input, which is articulated in our nonpartisan Patient Charter as well as in our 2017 health care principles. Both the Charter and health care principles specifically address this issue.

Patients will have limited cost sharing and will have predictable and affordable total out-of-pocket costs, including deductibles, co-pays, co-insurance, premium costs or contributions to premiums across care settings.

We remain committed to working with Congress, the Administration and other healthcare stakeholders to advance the following [priority]: Enhance affordability and reduce out-of-pocket costs by maintaining subsidies and seeking new, creative mechanisms to limit cost shifting to patients.

This announcement along with the executive order signed on October 12, 2017 will destabilize the individual market and remove critical protections for patients. The executive order removes protections for patients that require all health plans provide meaningful coverage and an appropriate scope of benefits. The executive order will also work against our health care principles that state patients should not be subject to pre-existing conditions and rating restrictions, nor should annual and lifetime caps on treatments and therapies apply.

Congress can and must act to create stability in the marketplace and to ensure changes to the health system work for all Americans, especially those living with debilitating conditions. Partners remains committed to working with Congress to ensure that every American has access to affordable, high-quality, patient-centered coverage in 2018 and beyond.

Partners members are patient advocacy organizations and a diverse group of healthcare stakeholders, including manufacturers and payers, representing more than 100 million patients living with a wide range of debilitating conditions. For more information about Partners, our health care principles or Patient Charter, please visit PartnersforBetterCare.org or contact Mary Richards, Executive Director, at MRichards@PartnersforBetterCare.org.