A coalition of organizations that includes the AAFP is pressing Congress and the White House to maintain federal funding that enables millions of Americans to obtain affordable health insurance.
Seven million people -- nearly 60 percent of individuals who purchase insurance on the marketplaces established by the Patient Protection and Affordable Care Act -- receive assistance that helps offset the cost of deductibles, copays and out-of-pocket costs. This federal funding is paid directly by HHS to insurers who offer plans on the marketplaces.
A lawsuit House Republicans filed against HHS questions the legality of these payments without an appropriation by Congress. A federal court ruled in favor of the plaintiffs, but the Obama administration appealed, arguing that the executive branch could authorize the payments. Both sides asked for a delay on the appeal after Donald Trump was elected president.
In letters sent April 12 to President Trump(2 page PDF) and leaders in the House and Senate, the AAFP and seven other organizations urged them to find a way to continue to provide the cost-sharing assistance.
"This funding helps those who need it the most access quality care: low- and modest-income consumers earning less than 250 percent of the federal poverty level," the letter stated.
The organizations said insurers could be driven out of the marketplaces if they can't count on continued funding for these cost-sharing payments.
The letter warned of the consequences of ending the funding. Individuals might drop their coverage, thereby increasing the ranks of uninsured. Fewer enrollees could lead to reduced participation by insurers and fewer choices for consumers.
Ending the funding would increase premiums in 2018 and beyond. Health policy analysts estimated that premiums could increase by 15 percent for all plans -- both on and off the marketplaces -- without continued federal support for cost-sharing.
"Higher premium rates could drive out of the market those middle-income individuals who are not eligible for tax credits," the letter stated.
There is also the risk that physicians and hospitals would see more uninsured patients.
"If more people are uninsured, providers will experience more uncompensated care, which will further strain their ability to meet the needs of their communities and will raise costs for everyone, including employers who sponsor group health plans for their employees," the letter stated.
The groups offered help in finding a solution.
"We are committed to working with you to deliver the short-term stability we all want and the affordable coverage and high-quality care that every American deserves," they wrote.
Besides the AAFP, the letter was signed by America's Health Insurance Plans, the American Benefits Council, the American Hospital Association, the AMA, the Blue Cross Blue Shield Association, the Federation of American Hospitals and the U.S. Chamber of Commerce.
Related AAFP News Coverage
AAFP Warns Congress About Flaws in Proposed ACA Replacement
American Health Care Act Would Hurt Physician-Patient Relationship, Increase Costs