News Headlines Article

Silver-loading complicates CSR lawsuits
Modern Healthcare

Insurers are so far undefeated in a string of lawsuits to recover billions in unpaid cost-sharing reduction payments cut off by President Donald Trump in 2017, following two federal court decisions late last week.

But with a winding legal path ahead and a policy mess no matter the outcome, it’s unclear whether any involved party—the government, the insurers or the people who pay full freight on the exchanges—will win.

At immediate issue is whether these accumulating insurer victories will tamp down on silver-loading, a practice widespread across nearly all states since Trump halted cost-sharing reduction payments, or CSRs. Silver-loading, what happens when exchange insurers pile the costs into the silver benchmark plans and pass them on to unsubsidized silver plan enrollees and the federal government, has proven extremely expensive for the government.