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Insurers should get unpaid ACA subsidies, appeals court rules


DP Veteran
Aug 10, 2013
Reaction score
Cambridge, MA
Political Leaning
Slightly Liberal
All the effort the GOP has wasted trying to undermine the ACA really could’ve been put toward doing something productive.

Insurers should get unpaid ACA subsidies, appeals court rules
A federal appeals court ruled on Friday that the Trump administration violated the law when it abruptly stopped paying for subsidies intended to reduce healthcare costs for low-income individuals who buy coverage on the Affordable Care Act exchanges.

In a separate decision also issued Friday, the same court said health insurers should not collect a windfall from the decision. While the U.S. Federal Circuit Court of Appeals said insurers are entitled to the full amount of unpaid cost-sharing reduction subsidies for 2017, the amount owed for 2018 should be reduced because insurers were able to raise premiums to make up for the loss of subsidies.
The ACA established cost-sharing reduction subsidies for individuals whose incomes were below 250% of the federal poverty level. The Trump administration ended these subsidies in late 2017, claiming that it lacked an appropriation. But the law still required insurers to reduce copayments and other cost-sharing for eligible individuals.

Insurers in 2018 hiked premiums for silver plans on the exchanges to make up for the lack of CSR payments. Because of the way ACA premium tax credits are structured, the federal government ended up paying substantially higher premium tax credits as a result.
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