On August 15, the Congressional Budget Office (“CBO”) released a report on the effects of terminating payments to insurers for cost-sharing reductions under the Affordable Care Act (“ACA”) in 2017. The CBO estimated that by 2018, insurance premiums for silver plans would increase by 20 percent and leave 5 percent of Americans living in areas without insurers in ACA marketplaces. The CBO also estimated that such a policy would increase the federal deficit by $194 billion by the end of 2026. The Trump Administration did continue the cost-sharing reduction payments for August. Senator Lamar Alexander (R-Tenn.), Chairman of the U.S. Senate Committee on Health, Education, Labor & Pensions, released a statement commending the President for continuing the payments and calling on Congress to pass bipartisan legislation in September that will fund cost-sharing payments for 2018 as well as provide states more flexibility in approving insurance policies. The Senate Committee on Health, Education, Labor & Pensions has scheduled hearings the first week of September on stabilizing the individual insurance market. Insurers are required to file their 2018 premiums by September 5 and states must submit completed rates to federal officials by September 20. Insurers must sign federal contracts to offer 2018 plans by September 27.
On August 16, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule to cancel the Episode Payment Model and the Cardiac Rehabilitation incentive payment model. Currently, both incentive payment models become mandatory for providers beginning on January 1, 2018. CMS also proposed to reduce the number of mandatory geographic areas participating in the Comprehensive Care for Joint Replacement Model and to make participation in the model voluntary. Comments on the proposed rule are due by October 16.