On Friday, news broke nationwide that the Trump administration would be ending a part of the Affordable Care Act called Cost-Sharing Reduction (CSR) payments. These payments function as subsidies which are sent to insurance companies that, in turn, use them to cover the costs of insuring low-income recipients of ACA-mandated health insurance plans. The news is a worry to many health insurance providers, but Montana Blue Cross Blue Shield (BCBS) spokesman John Doran, says it is something BCBS anticipated with their 21.3 percent average increase this year.

"We built this uncertainty into our market and into our 2018 rates and that is attributable to 17. 3 percent of that increase," Doran said. "We anticipated that this could be a likely scenario and we were the only carrier in Montana to do so... that represents the financial impact we anticipated if the CSR's were not going to be paid."

Doran was unable to give the total amount of CSR payments received by BCBS, but says that nothing will change in the 2018 plans already set to hit the marketplace November 1. However, Doran did infer that the lack of CSRs could drive providers out of the Affordable Care Act individual marketplace.

"It's a substantial amount, I mean, it's the difference between having sustainable products on the marketplace and not having products on the marketplace," Doran said.

At this point, it is still unclear when the subsidies will come to an end. Montana Insurance Commissioner Matt Rosendale says he will discuss the matter when more details are available.

Update- Rosendale's office sent out the following statement:

As Commissioner of the Montana Department of Insurance I have been notified by the Center for Medicare and Medicaid services that Montana health insurers are ineligible for a re-filing of adjusted insurance rates for 2018.

We must focus our attention on the underlying problem which is affordable health care. Continuing to throw billions of dollars at insurance companies or turning our health care system over to the government as some would have us do is not a viable solution.

Absent additional guidance from CMS, the current rates and plans as posted on the CSI website will be offered at open enrollment for purchase beginning on November 1st to become effective on January 1, 2018.

Any Montana consumer who purchases these products can be assured that my office verified that Montana’s insurers, whether receiving subsidies or not, are financially able to provide the benefits for the posted rates regardless of action taken at the federal level.