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On October 13, the President announced that he will no longer fund Cost Share Reduction (CSR) payments that help reduce out of pocket costs for individuals and families. This takes effect immediately, and is a significant blow to any insurance company that is still offering coverage in the individual Marketplace.

Cost Share Reduction plans help more than 65% of our members afford their health care. These plans lower deductibles, copayments and coinsurance so that when lower income members seek health care, the cost of that care doesn’t become a huge financial burden on their families. The law says the federal government will pay for these plans, but some in Congress say they did not appropriate the money, and they won a court case that gives the president the ability to cut off the CSR payments.

The President’s decision to pull the funding from these plans is the latest setback in a string of events that have created financial difficulties for insurance companies and consumers alike over the past couple of years. Changing the rules overnight creates an incredible amount of stress on an already stressed system, and the burden unfortunately falls on the backs of average consumers, even those not receiving Cost Share Reductions and subsidies.


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Why end these payments now? The uncertainties around these payments had already caused Wisconsin insurers to increase their rates starting on January 1, 2018. By stopping the payments when he did, the President guarantees that insurance companies will take a significant financial hit in 2017 that will translate into more expensive premiums for consumers down the road. Some companies may pull out of the market – CGHC will not.

We want our members to know that we will continue to serve them and our members who receive Cost Sharing Reduction plans will not lose these benefits. It’s part of our mission to fight for what’s best for our members. But the fact is that your non-profit cooperative will take another financial hit this year.

Many people voted for the President because they wanted to see improvements to the health insurance market. They did not want him to make it worse. This action only makes things worse where there was an obvious choice to do better. Please work with us to urge Congress to do its job and get something done to stabilize the insurance market and help us lower premiums for consumers. It’s imperative they act as quickly as possible before the individual insurance market is broken beyond repair.

Visit our Knowledge to Action page to learn how to contact Congress.

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