Defunding CSRs: Challenges and Options

Wakely experts address key questions and considerations around Cost-Sharing Reduction plan reconciliation in light of defunding of CSR subsidies.

On October 13, 2017, with less than three months left in 2017 and just a few weeks until the start of 2018 open enrollment, issuers received notice from Centers for Medicare & Medicaid Services (CMS) indicating that payments for the cost sharing subsidies would be ending immediately. This change overturns a funding source that issuers offering individual plans on Health Insurance Exchanges had been receiving since 2014. While this change has many downstream impacts on rating and risk adjustment, this summary focuses on the considerations for Cost Sharing Reduction (CSR) plan reconciliations.

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