The Centers for Medicare and Medicaid Service says it will end the Affordable Care Act cost-sharing reduction subsidy in such a way that the program will pull money out of health insurers, rather than paying any more money into health insurers.
CMS officials talk about subsidy program shutdown procedures in a document posted Monday, on a semiprivate technical assistance website.
The subsidy has been helping 6 million low-income Affordable Care Act public exchange plan users pay their health coverage deductibles, co-payments and coinsurance amounts. Trump administration officials say they lack a valid congressional appropriation to make the payments and will stop making the payments immediately, starting with a round of payments insurers were expecting to get last week.
A federal judge is holding a hearing on the subsidy cut-off later today and could issue an injunction that would require the government to continue making the payments, or affect how the government implements a subsidy payment cut-off.
CMS, an arm of the U.S. Department of Health and Human Services, has been making subsidy payments in advance, based either on insurer enrollment database files or, in some cases, enrollment spreadsheets.
CMS has been going through a monthly reconciliation process with insurers to adjust final subsidy payment amounts to reflect final and complete enrollee coverage information.