Is Tiptoeing Toward Short-Term Health Plans 'a Step in the Wrong Direction'?

The most successful attempt this country ever made at catching up with the rest of the industrialized world and the primary policy goal of conservative Republicanism is to gut it and return us all to the status quo ante.

When Trump administration's senior HHS staff unveiled a draft rule this week that would expand the sale of cheap, skimpy, short-term health plans, they described it as a "lifeline" for the now uninsured, and insisted the rule change won't destabilize Obamacare's individual market.

Idaho's brashness and the Trump administration's ambivalence are setting up maybe the most interesting health care legal quandary since King v. Burwell, the Supreme Court case that alleged Obamacare's premium subsidies weren't allowed in states that had marketplaces run by the federal government.

Short-term health insurance plans are created to provide coverage to individuals moving between comprehensive health insurance plans - when switching employers, for example.

The companies would be allowed to exercise all kinds of flexibility they used to have on the individual market and no longer do on yearlong plans: to deny coverage for pre-existing conditions, to charge more for sicker people, and to exempt some services, such as prescription drugs, from coverage at all.

There's no doubt this is going to be bad news for Obamacare. And the GOP did manage to repeal the individual mandate - effective as of 2019 - as part of its tax cuts. The Trump administration actually encouraged states to apply for waivers that would cover much or all of the cost of setting up reinsurance systems, but it has recently sent mixed signals about its intentions. "But next year, without the mandate, short-term plans would likely attract more enrollees". This will, of course, render the risk pool even sicker than it is today, and it will accelerate the "death spiral" that is already well under way. They jack the prices when insurers are paying, because the insurers have deep pockets and will pay.

As I've mentioned a number of times, none of this will impact the people at the low end of the income scale who are getting their Obamacare insurance for free or almost for free.

Overall, that number has jumped from one in every four plans in 2010 to more than 43 percent of plans by 2017, the CDC investigators found.

The Trump administration on Tuesday laid out its plan to allow yearlong health insurance coverage that is skimpier, noncompliant with Obamacare standards - and far less expensive. It said it would begin marketing five new plans next month. "A lot of people buy them thinking they're comprehensive insurance and will provide financial protection to them, only to find out to their dismay that they don't cover very much at all". Verma said people who buy the limited plans could face federal penalties this year for violating the mandate. But he predicted middle-class people would get hit hard.

A few miles away in another wooded suburb, Emilia DiCola, 28, an aspiring opera singer who scrapes by with gigs at churches and in local theaters, has no such complaints. The plans do not have to meet all of the Affordable Care Act's requirements. The moves are an alternate route given the Republican-led Congress' inability previous year to dismantle much of the law, although Trump has urged lawmakers to try again, despite GOP Senate leaders' reluctance.

Asked specifically about a different but related matter, whether he would intervene in Idaho where one insurer has filed plans that openly defy the ACA and some say break the law, Azar said he was not in a position to rule on the issue. The objective of the questions is to ensure applicants do not have expensive chronic health conditions that are ill suited for a temporary insurance product whose enrollees pay premiums for less than a single year. Taxes would need to go up dramatically to pay for it. And it recently began allowing states like Kentucky to take Medicaid benefits away from people who are not employed, creating a system of red tape meant to hurt poor people who have lost their jobs or are unable to work.

  • Leroy Wright