October 20, 2017

state announcement about cost-sharing reduction payments

From Oregon Dept. of Consumer & Business Services,

STATE ANNOUNCEMENT REGARDING TRUMP ADMINISTRATION DISCONTINUATION OF COST-SHARING REDUCTION PAYMENTS

Salem -- On Oct. 12, the Trump administration issued an announcement about stopping cost-sharing reduction payments to health insurance companies immediately. The Oregon Department of Consumer and Business Services (DCBS) is committed to the stability of Oregon's health insurance market and ensuring access to statewide comprehensive health coverage. After analyzing the announcement and its implications, DCBS has determined that there will be no change for 2017 health plans and is implementing a plan to ensure stability beyond this year.

"Oregonians can be assured that their 2017 plan rates and benefits will not change today or through the end of the year," said Jean Straight, acting DCBS director. "Premiums will not change, premium assistance through HealthCare.gov will not change, and working families in Oregon who are enrolled in cost-sharing reduction plans can continue to access this important type of assistance."

In order to ensure carriers can continue to offer coverage in Oregon, DCBS is ordering health insurance companies offering plans on HealthCare.gov to increase their already approved silver metal tier 2018 plan rates by 7.1 percent.

Non-silver metal tier plan rates (e.g., bronze and gold) will remain unaffected.

This increase will affect plans both on and off HealthCare.gov, and will compensate for the $49 million worth of cost-sharing reduction payments that the federal government will no longer be making to Oregon insurance companies in 2018.

"These rate increases are necessary to ensure the stability of the health insurance market," said Acting Director Straight. "Oregonians who receive financial assistance through the Marketplace will find that premium assistance will also increase, shielding them from most of the increase."

Oregonians who do not qualify for premium assistance through HealthCare.gov are encouraged to work with an agent to shop around and consider a non-silver level plan that might work for their situation.

Open enrollment for 2018 plans begins Nov. 1 and runs through Dec. 15, 2017. Oregonians are encouraged to work with an agent or community partner to find the best plan for their situation. Due to these additional rate increases on silver metal tier plans, it is especially important to apply for financial assistance through HealthCare.gov.

What are cost-sharing reduction (CSR) plans?
In addition to providing help paying for premiums, the Affordable Care Act requires Marketplace insurers to offer cost-sharing reduction plans to middle-income consumers (under 250 percent of the federal poverty level). These are silver-level plans with lower maximum out-of-pocket limits, deductibles, co-pays, and co-insurance, making access to health care services more affordable. About 50,000 Oregonians were enrolled in cost-sharing reduction plans.

The Department of Consumer and Business Services is Oregon's largest business regulatory and consumer protection agency. Visit www.dcbs.oregon.gov.

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