Donna Shalala: “This amendment expresses the sense of Congress that the secretary should not do anything that prohibits State insurance…”

“This amendment expresses the sense of Congress that the secretary should not do anything that prohibits State insurance commissioners from allowing for so-called silver loading. Let me walk you through how we got to this point. Because while silver loading has worked to keep costs on the exchange lower for folks who get subsidies, it has only been used because the President was actively trying to kill the Affordable Care Act. In 2017, the President decided to stop reimbursing health insurance companies for what are called cost-sharing reductions, or CSRs. CSRs are payments that health insurance companies are required to make to help low- and moderate-income people afford healthcare. Under the Affordable Care Act, the health insurance companies must help people that have more affordable, and, possibly, no co-pays or deductibles. The Federal Government was supposed to reimburse insurance providers for making these payments; however, in October of 2017, the administration stopped making these payments. This was a deliberate attempt to make health insurance on the exchange unaffordable, and undermine, weaken, and attack the Affordable Care Act. In response to this, States let health insurance plans do what is now called silver loading. State insurance regulators, in a desperate and creative attempt to stabilize the insurance marketplaces, allowed insurance companies to bill the unpaid CSR costs into their silver plans on the exchange.…”