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May 19, 2017

AGs fearful Trump won't defend subsidies

Attorney General Maura Healey.

Bay State Attorney General Maura Healey joined with her legal counterparts in 14 other states and the District of Columbia on Thursday attempting to intervene in a federal lawsuit that could jeopardize tens of millions of dollars in federal subsidies used to make health insurance more affordable for almost 250,000 state residents.

The attorneys general, led by California and New York, filed a motion to become a defendant in the lawsuit House v. Price, which was initially filed by House Republicans against the Obama administration.

The Democratic lawyers said in the motion they no longer trust the Trump administration to defend the subsidies, which are the subject of an appeal and if eliminated, they said, could undercut the affordability of health plans offered through state insurance exchanges.

"Despite repeated attempts by the Trump Administration and the Republican Congress to sabotage the Affordable Care Act, it remains the law of the land. We've moved to intervene today to protect critical federal payments that support health care in our state," Healey said in statement.

The GOP-led House challenged the legality of cost-sharing reduction (CSR) payments made under the Affordable Care Act to reduce out-of-pocket expenses such as co-pays and deductibles for lower-income Americans.

A U.S. District Court judge sided with the House, ruling that the payments were unconstitutional because the Congress had not appropriated the money to pay for the subsidies. Her ruling was suspended pending an appeal, and a status hearing is scheduled for Monday.

The CSRs are available for individuals and families with incomes up to 250 percent of the federal poverty level, or about $60,625 for a family of four. According to Massachusetts insurers, 244,400 enrollees in 2016 benefited from CSRs, and insurers could lose as much as $125 million in 2018 without the payments.

"The impact of the elimination of these significant financial subsidies on the cost of health care cannot be overstated. Without funding, thousands of Massachusetts residents who buy their own plan will be harmed as the loss of CSR funding will cause their premiums to go up sharply," a coalition of Massachusetts insurers, business groups and unions wrote to U.S. Sen. Elizabeth Warren last month.

Though the White House agreed last month to continue the payments as part of a deal with Congressional Democrats to keep the government funded, the attorneys general worry that the Trump administration could choose eventually to drop the appeal.

"The President has increasingly made clear that he views decisions about providing access to health insurance for millions of Americans-including the decision whether to continue defending this appeal-as little more than political bargaining chips," the motion states. "The States and their residents cannot continue to rely on the Executive Branch to represent them in this appeal."

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