AHIP’s Letter To The Wall Street Journal: CSR Benefits, Not Bailouts

by David Merritt

August 8, 2017

David Merritt, AHIP’s EVP of Public Affairs, weighed in with the Wall Street Journal on the need for cost-reduction benefit funding, which is about keeping coverage affordable and protecting consumers. Read full letter to the editor below.


“The Coming ObamaCare Bailout” (Review & Outlook, Aug. 3) exploits a political buzzword to argue for a policy that would further destabilize the individual insurance market. Let’s look at the facts.

First, health plans do not keep a single dime from this program. This funding is passed directly through to doctors, hospitals and pharmacies on behalf of patients—and only for care that’s actually provided. Hardly a bailout.

Second, eliminating this funding now would create something akin to an unfunded mandate. If health plans are required by law to offer these lower deductible and cost sharing plans to lower-income people without being reimbursed, this de facto mandate on the private sector will drive up premiums by approximately 20% for all consumers who purchase their own coverage.

Third, eliminating this funding now would hurt states, doctors, hospitals and hardworking taxpayers. Recent studies show that the resulting higher premiums would cost taxpayers $2 billion more in additional spending. States, as shown by a federal court decision earlier this week, would face new uncompensated care costs because public hospitals would care for more uninsured patients. Same goes for many doctors.

It’s time to focus on real solutions. Let’s keep the market stable so that Congress, the administration and the private health-care sector can work together on long-term solutions that actually work. Otherwise, there may not be an individual insurance market to improve.”