Cost-Sharing Reductions, Technocrat Tinkering, and Market-Based Health Policy

Journal of Law, Medicine & Ethics, vol. 46, p. 873, 2018

U of Penn Law School, Public Law Research Paper No. 20-26

7 Pages Posted: 13 Aug 2020

See all articles by Allison K. Hoffman

Allison K. Hoffman

University of Pennsylvania Carey Law School

Date Written: 2018

Abstract

The Trump Administration has exposed both the durability and vulnerability of the Patient Protection and Affordable Care Act’s insurance reforms. One of the Administration’s first strikes at “Obamacare” was to discontinue federal government payment of cost-sharing reductions, which insurers pay to low-income enrollees on the exchanges to reduce their out-of-pocket share of medical spending. The states struck back with a clever solution that could hold insurers and enrollees harmless. This Article examines this strategy and why, while impressive, it reaffirms larger problems with the ACA’s market-based approach to health reform and the need for new pathways forward.

Keywords: Health law & policy, insurance regulation, Patient Protection & Affordable Care Act, PPACA, ACA, insurance exchanges, Obamacare, cost-sharing reduction payments, CSRs, premium subsidies, market-based reform, bureaucracy

JEL Classification: H51, I13, I18, K23

Suggested Citation

Hoffman, Allison K., Cost-Sharing Reductions, Technocrat Tinkering, and Market-Based Health Policy (2018). Journal of Law, Medicine & Ethics, vol. 46, p. 873, 2018, U of Penn Law School, Public Law Research Paper No. 20-26, Available at SSRN: https://ssrn.com/abstract=3671889

Allison K. Hoffman (Contact Author)

University of Pennsylvania Carey Law School ( email )

3501 Sansom Street
Philadelphia, PA 19104
United States

HOME PAGE: https://www.law.upenn.edu/cf/faculty/ahoffma1/

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