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$47 Billion More in Federal Spending over 10 years and Smaller Marketplaces
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In House v. Burwell, the House of Representatives claims that the cost-sharing reductions (CSRs) paid under the Affordable Care Act (ACA) to low-income enrollees in Marketplace coverage were inappropriate because Congress had not specifically appropriated funds for them. We estimate the ramifications of eliminating federal reimbursement of CSRs using the Urban Institute’s Health Insurance Policy Simulation Model. Because the ACA requires insurers to provide low-income Marketplace enrollees with the reductions regardless of explicit funding, we assume that insurers would build these costs into the premiums for Marketplace silver plans.