WASHINGTON – U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) today asked Virginia's top insurance regulator to inform consumers about the health insurance cost increases many are experiencing because of the Trump Administration's threats to stop paying billions of dollars in cost-sharing subsidies that lower the out-of- pocket medical costs for millions of consumers. The Senate Republican health care proposal, negotiated in secret over several weeks, has not yet been publicly shared with states, Democratic colleagues, or the public.

This hedging by the Trump Administration and Congressional Republicans has created wild uncertainty in the Affordable Care Act (ACA) marketplace, and the impacts have become clearer as insurers file proposed rates for plans they will sell there. Because of President Trump's deliberate decision to maintain a high level of uncertainty over the continuation of these ACA subsidies, many insurers have filed significant rate increases that will hurt lower-income families as well as middle-class Virginians who earn too much to qualify for premium assistance under the law and will bear the full brunt of any rate increases.

Fifty-six percent of Virginians who buy insurance in the ACA marketplace rely on cost-sharing reductions to keep their health care costs affordable. In fact, in some Virginia localities—including Lee, Scott, Wise, Halifax, Sussex, Accomack, Page, Madison, Rappahannock, and Richmond counties—approximately 100% of marketplace enrollees receive some form of cost sharing reduction.

"Despite the importance of these payments, the current Trump Administration has refused to say whether it will continue to provide these important cost-sharing reductions for longer than a month at a time," Sens. Warner and Kaine write in a letter to Virginia Insurance Commissioner Jacqueline Cunningham. "In the absence of that commitment, insurers face enormous uncertainty that is directly impacting their 2018 premium proposals."

Sens. Warner and Kaine are asking the commissioner request that insurers providing health coverage in Virginia report two sets of proposed 2018 premiums: rates that reflect the continuation of cost-sharing reductions, and rates that would apply if those subsidies end.

The full text of the letter to Commissioner Cunningham is available here and below.

June 21, 2017

Jacqueline K. Cunningham
Commissioner of Insurance
Bureau of Insurance
State Corporation Commission
P.O. Box 1157
Richmond, VA 23218

Dear Ms. Cunningham:

We write to you regarding the filed 2018 insurance premium rates in Virginia. It is critically important that Virginians understand all the factors that contribute to the cost of their premiums for insurance coverage in 2018. The Bureau of Insurance plays a vital role in ensuring that Virginians do not pay more than a reasonable rate for their health coverage in the individual market. We encourage you to use your position to provide Virginians with as much information as possible about their health insurance coverage choices. 

Fifty-six percent of Virginians who buy insurance in the Marketplace rely on cost-sharing reductions (CSRs) to keep their health care costs affordable. In fact, in some counties, including Alleghany, Buchanan, Bland, Carroll, Covington, Dickenson, Emporia City, Grayson, Mecklenburg, Norton City, Scott, Smyth, Wise, and Wythe, approximately 70% or more of Marketplace enrollees receive some form of cost sharing reduction. With the passage of the ACA, the federal government committed to offering these CSRs to help families and individuals reduce their deductibles, copays, coinsurance, and out of pocket maximums.

Despite the importance of these payments, the Trump Administration has refused to say whether it will continue to provide these important cost-sharing reductions for longer than a month at a time. In the absence of that commitment insurers face enormous uncertainty that is directly impacting their 2018 premium proposals. Insurance commissioners in other states have recognized this and asked their insurers to report two sets of proposed premiums: 1) rates that reflect continued cost-sharing reductions, and 2) rates that apply if cost-sharing reductions end.

Although Virginia insurers have already filed their rates, we encourage you to ensure that Virginians are informed about the likely impact that this uncertainty will have on their premiums. First, we suggest that you ask each insurer that has filed individual market premiums in Virginia: 1) whether those premiums assumed that cost-sharing reductions will continue through the entire year, and 2) the average percentage impact the assumed cost-sharing reductions had on those premiums. It is important for us all to understand the overall impact of this uncertainty on the Virginia insurance market.

We also encourage you to request that those insurers that assumed the cost-sharing reductions would continue disclose that fact in their 2018 Notice to Beneficiaries, and disclose the estimated impact on premiums if the cost-sharing reductions are discontinued, so that consumers can understand the potential future impact on their own personal finances.

It isn't just the concern hanging over cost-sharing reductions that is driving up premiums around the country. Insurers also say that the uncertain future of the individual shared responsibility provision is forcing them to either increase premiums much more than they otherwise would, or to pull out of marketplaces altogether. This willful creation of chaos and uncertainty is unacceptable and dangerous, and threatens the health insurance coverage of millions of Virginians.

We look forward to your response, and to working with you to ensure that Virginians have access to every available resource to keep health care costs affordable. Thank you for your timely attention to this request. If you have any additional questions, please contact our offices.

Sincerely,

Mark R. Warner                                                                      Tim Kaine
United States Senator                                                             United States Senator

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