 Centers for Medicare and Medicaid Services Administrator Seema Verma (center). (Jonathan Ernst/Reuters) By Carolyn Y. Johnson Health insurance executives seeking certainty on the future of federal funds that help lower-income Americans with their out-of-pocket health-care costs got no commitment that they would be paid next year in an hour-long meeting with Seema Verma, administrator of the Centers for Medicare and Medicaid Services (CMS), according to two insurance industry officials with knowledge of the meeting. A CMS official confirmed that Verma "did not comment" on the payments, called cost-sharing reductions, at the meeting and told those gathered that it was a decision to be made by Congress. Cost-sharing reductions are federal payments to insurers that help defray deductibles and co-pays for more than 7 million Americans who buy insurance through the Affordable Care Act marketplaces. In a lawsuit that has dragged on for years, the way the payments are funded has been successfully challenged in court by House Republicans. The decision was appealed by the Obama administration, and the case has been inherited by the Trump administration. The case was put on hold while Republicans tried to repeal the Affordable Care Act, and payments are being made while the lawsuit proceeds. It has remained unclear how the issue will be resolved, and President Trump increased the uncertainty last week when he suggested in an interview with the Wall Street Journal that withholding the funds, which are projected to add up to $10 billion in 2018, could be a way to bring Democrats to the table to work together on health-care reform. One way for the payments to be made would be for them to be funded in the spending bill that must be passed by April 28 to avoid a government shutdown. Trump told the Journal that he and Congress would both have to approve the payments. | 
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