Molina Healthcare Inc. said in a letter to Congressional leaders Thursday that if cost-sharing payments that are part of the Affordable Care Act aren't funded it has "no choice" but to pull out of the health law's marketplaces immediately. "That would result in about 650,000 to 700,000 people losing insurance coverage in 2017, and we would not participate in Marketplace in 2018, resulting in over 1 million Americans losing health insurance coverage," the letter -- first reported by news outlet Axios -- said. The subsidies allow health insurers to provide health plans with lower cost-sharing to low-income individuals, and have become a point of contention in a government spending measure that would avert a shutdown. Molina, which described itself as one of the largest participants in the ACA's marketplaces, is one of the few health insurers to make money on the exchanges. In the Thursday letter, the company directly refuted a claim made by President Donald Trump that the payments amounted to "bailing out insurance companies." The payments reduce co-pays and deductibles for eligible low-income members and are used directly to pay the provider, Molina Chief Executive Officer J. Mario Molina said. "Thus, this is not a bail-out or windfall to the insurance company," he said. Molina shares have declined 15.3% over the last three months, compared with a 4.1% rise in the S&P 500 .
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