We also encourage you to request that those insurers that assumed the cost-sharing reductions

would continue disclose that fact in their 2018 Notice to Beneficiaries, and disclose the estimated
impact on premiums if the cost-sharing reductions are discontinued, so that consumers can
understand the potential future impact on their own personal finances.

It isn't just the concern hanging over cost-sharing reductions that is driving up premiums around
the country. Insurers also say that the uncertain future of the individual shared responsibility
provision is forcing them to either increase premiums much more than they otherwise would, or
to pull out of marketplaces altogether. This willful creation of chaos and uncertainty is
unacceptable and dangerous, and threatens the health insurance coverage of millions of
Virginians.

We look forward to your response, and to working with you to ensure that Virginians have
access to every available resource to keep health care costs affordable. Thank you for your timely
attention to this request. If you have any additional questions, please contact our offices.

Sincerely,

Mark R. Warner
)L __ Tim Kine
'
United States Senator United States Senator