The ACA’s Unconstitutionality Could Cost Us All.ACA requires health insurers to offer reduced copays and deductibles to Obamacare Silver Plan customers with incomes 100 to 250 percent of the federal poverty level, i.e., incomes up to $61,500 for a family of four.
To help insurers afford these discounts, federal taxpayers make cost-sharing reduction (CSR) payments to insurers. These payments will cost $7 billion in 2017, $10 billion in 2018, and $16 billion in 2027, according to a Congressional Budget Office report quoted by KFF’s April 25 Issue Brief, “The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments.”
Federal District Judge Rosemary Collyer ruled CSR payments unconstitutional in May 2016 because Congress never made an appropriation for them. Article I, Section 9, Clause 7 of the U.S. Constitution reads, in part, “No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.” In the Court’s opinion, Collyer wrote, “The Affordable Care Act unambiguously appropriates money for Section 1401 premium tax credits but not for Section 1402 reimbursements to insurers” (emphasis added). Thus, CSR payments are unlawful. If Payments Stop, Premiums Will Skyrocket.
