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Nebraska Appleseed Says Congress Needs to Reinstitute CSRs


Nebraska Appleseed is paying close attention to the impact of the President’s decision to stop the Cost Sharing Reduction payments (CSRs) to insurers on the ACA. 

The Deputy Director of their Healthcare Access Program, attorney Molly McCleery, says with or without the CSR reimbursements, insurance companies are required to keep the out-of-pocket costs low for customers with incomes of between 100% and 250% of the federal poverty level.  She says for a family of four this means up to around $60,000 per year. 

McCleery says since those earning between 100% and 400% of the federal poverty level qualify for subsidies for their insurance premium costs – if their premiums go up, their subsidies will also. 

“Last year we saw about half of our Marketplace enrollees were able to get this Cost Sharing Reduction, which means they were on the sort of lower end of the income spectrum, which means they would get higher subsidies. So, I think people will be pleasantly surprised about what the sticker price looks like when they look at”

McCleery says those who earn too much to qualify for subsidies will feel the brunt of increases that result from stopping the CSR payments. For individuals, this means an income of just over $48,000 per year.

For 2018, Medica, and in Eastern Nebraska Medica with CHI, are the only insurers on the Nebraska Marketplace. McCleery says although insurers planned for the possible stoppage of CSRs when setting  their 2018 premiums, there is genuine cause for concern about the ACA for 2019 if Congress does not reinstitute these CSRs .

ACA open enrollment for next year starts November 1st.

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