In October 2017, the Trump administration stopped compensating insurers for providing cost-sharing reductions through the CSR Program, citing the fact that Congress never formally appropriated the funds for this purpose and, thus, their distribution by HHS was illegal. This discontinuation of federal payments for the CSR Program was known as “CSR defunding.”
The Obama administration previously worked around the lack of an appropriation and made CSR payments to insurers from funds appropriated for other purposes. The U.S. House of Representatives sued to block these payments, and the federal courts sided with the House, citing the Constitution’s Appropriations Clause. Since October 2017, insurers have not received direct CSR payments from the federal government.
The continuation of CSR plans has been largely accomplished through incorporating CSR expenses into the premium price for silver plans, a practice known as “silver loading.”
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