Senior Fellow and Director of Research, Health Policy @centeronbudget. Former Dep. Director for Economic Policy at OMB. Music lover. Views expressed are my own.
Gideon Lukens
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Make no mistake: directly funding CSRs is a major cut to the #ACA marketplace. And it comes on top of huge premium hikes and coverage losses for millions of ppl due to the Republican reconciliation bill and marketplace rule changes. tinyurl.com/ycyypjrc
Congressional Republicans failed to extend premium tax credit (PTC) enhancements at the end of 2025, and now the harm of higher marketplace premium costs is beginning to show up.
tinyurl.com
Enrollees in the highest income group would tend to see lower premiums, but they are greatly outnumbered by enrollees with moderate incomes who would face higher premiums.
Directly funding CSRs would reduce those tax credits for millions of ppl with moderate incomes, who would then face higher out-of-pocket premiums.
CSRs help marketplace enrollees with lower incomes pay for deductibles and other cost sharing. Insurers are required to offer CSRs, and they indirectly recover this additional expense from the fed govt through higher premium tax credits.
