Skimpy health insurance plans & pre-existing conditions are back under new Trump rule

Officials unveiled a final rule that will make it easier to obtain coverage through short-term health insurance plans which don't have to adhere to the law's consumer protections

Officials unveiled a final rule that will make it easier to obtain coverage through short-term health insurance plans which don't have to adhere to the law's consumer protections

Under the Affordable Care Act, insurance companies are required to spend 80 to 85 percent of their premiums on health care or refund money to their customers.

The Trump administration on Wednesday cleared the way for insurers to sell short-term health plans as a bargain alternative to pricey Obama-law policies for people struggling with high premiums. Plans will carry a disclaimer that they don't meet the Affordable Care Act's requirements and safeguards.

The administration's short-term plan proposal was widely criticized by patient advocacy and hospital industry groups, saying it could leave people without coverage when they get sick.

"We continue to see a crisis of affordability in the individual insurance market, especially for those who don't qualify for large subsidies", CMS Administrator Seema Verma said in a statement.

Ronnell Nolan is CEO of the group Health Agents for America.

"If you get cancer, your plan will not cover oncology drugs, which can cost an average of $10,000 a month" and "if you are pregnant, you will have to find another way to pay for the cost", averaging about $32,000 for prenatal care and delivery, the center said in a recent post.

Brokers can make commissions of about 20% on short-term plans, compared with 5% on ACA plans. As Bloomberg has reported, many short-term plan enrollees have been hit with unexpected costs and denied coverage when seeking benefits. Both can have bigger price differences between older customers and younger ones.

"The Affordable Care Act left about 28 million Americans without insurance even though it promised to provide affordable insurance to everybody, and for those who have it, premiums doubled over the course of President Obama's tenure", Azar said on CNBC on Wednesday.

Loosening Obamacare's rules protecting those with pre-existing conditions also risks a backlash from the public since these protections are among the health reform law's most popular provisions.

During the Obama administration, health officials became concerned that, as premiums for ACA health plans were becoming more expensive, some people were starting to rely on these alternatives as an end-run around the comprehensive coverage the law was created to promote.

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Have you ever had a short-term insurance policy?

The administration said the plans can last up to 12 months and will be allowed to be extended to a maximum of three years - reversing Obama-era rules that limited the coverage to no more than three months.

Short-term plans join "association health plans" for small businesses as the administration promotes lower-cost health care options that cover less.

A return to the pre-ACA days of health insurance is a return to the days of lifetime and annual limits on coverage. The tax bill approved previous year by Congress stops this financial penalty as of 2019. "And of course if you have any kind of pre-existing condition, or you want to have a baby or you're expecting to have serious medical needs taken care of these are not the plans for you", she says.

Senate Minority Leader Chuck Schumer of NY says Democrats will "do everything in our power" to stop the Trump administration's expansion of short-term health insurance plans.

In an April analysis, the Kaiser Family Foundation found that the short-term plans sold by two online private insurance marketplaces, eHealth and Agile Health, often charge one-fifth the premiums for the lowest-run ACA health plans.

Just 29% cover prescription drug costs.

An Urban Institute study last winter estimated that 4.2 million people would enroll in the expanded version of short-term plans the administration had in mind.

Baldwin, a member of Senate Committee on Health, Education, Labor and Pensions, said Trump has been sabotaging the health system "by undermining guaranteed health protection and access to affordable care", which has resulted in "severe instability", and notable premium spikes in Wisconsin earlier this year.

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