Finding and enrolling in quality health insurance in 2019 will be more difficult due to a rule recently issued by the Department of Health and Human Services (HHS). This rule, allows substandard insurance plans, known as “short-term, limited-duration” or “short-term plans” to be sold alongside plans that cover comprehensive medical benefits as required by the Affordable Care Act (ACA).
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Expanding the availability of short-term health plans will increase costs for consumers with pre-existing conditions who require comprehensive health insurance, offer fewer benefits, and put more consumers at risk. The rule will extend the availability of these products from their current limit of 90 days, to 364 days – one day shy of an ACA compliant 1-year plan. Often referred to as “high-risk, low-quality”, these plans have historically been riddled with fraud and misleading sales tactics that put patients at risk. Today, short-term plans operate outside the ACA’s patient protections which require insurers to include 10 categories of services known as the “essential health benefits” or EHBs such as prescription drugs, emergency room care, access to rehabilitative services, maternity and infant care, preventive screenings among others.
These guaranteed benefits are the core of what patients across the country have come to rely on to maintain and improve their health. While short-term plans are a cheaper than comprehensive plans, they can – and have - put millions of patients and consumers at risk. Prior to the enactment of the ACA, short term plans regularly denied coverage to people with pre-existing conditions, charged incredibly high rates for certain groups people (such as women) and refused coverage for medically necessary services. While some proponents of the rule claim it will decrease consumer costs and offer more choice, in actuality, it could damage the both the health and financial wellbeing of those that choose to enroll in these plans.
There is significant evidence that demonstrates these plans will lead to more and higher out of pocket expenses for patients. The rule would also greatly increase premiums for patients that require comprehensive coverage. Because short-term plans are exempt from covering medical services like prescription drugs, many patients would be unable to afford even the basics (like blood pressure medication, or preventive check ups) if they could get coverage at all.
This rule is a win for some companies that want to offer short-term plans as a way to decrease costs and increase profits. But it is our job to make sure that patients come first by telling our state regulators and legislators to limit the sale of these plans.
Access to comprehensive, affordable health insurance is essential to reducing heart disease and stroke, and these short-term plans will do the exact opposite. For more information about short term plans and the Association’s efforts to preserve and expand important patient protections, see:
- Statements
- 1000 cuts letter
- Articles from NYT, KFF, CHIR
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