Blog Posts > Trump’s short-term Health Plans Not the Answer for WV

Trump’s short-term Health Plans Not the Answer for WV

Written by Kelly Allen on August 10, 2018

Charleston Gazette-Mail – Last Wednesday, the Trump administration issued new regulations that will expand the availability of “skimpy” short-term health plans. The U.S. Department of Health and Human Services touted this move as an effort to give Americans more affordable health coverage options, but there is a reason that skimpy plans cost less — they don’t cover much of anything. Story link.

The Affordable Care Act required that health plans cover everyone, regardless of their pre-existing conditions, health status, gender and age. The ACA also mandated that plans cover all essential health benefits, including mental health, substance use treatment, and maternity services. Before the ACA, three in four health plans in the individual market did not cover delivery or maternity care. 45 percent of pre-ACA non-group plans did not cover substance use disorder services.

Short-term plans are not required to meet ACA standards. Traditionally, they have only been available to customers for up to three months, as an option for a person with a short-term gap in coverage. But the Trump administration’s expansion of short-term plans will allow individuals to purchase these plans, which do not cover pre-existing conditions or many essential services we have come to expect following the ACA’s passage, for as long as twelve months. And unfortunately, short-term plans can often be difficult for shoppers to distinguish from ACA-compliant plans (aside from the fact that they are not sold on healthcare.gov). They are not clearly identified, and many people don’t realize they’ve purchased these plans until they need something that it not covered. The availability of these plans for a full year will likely only exacerbate the confusion.

Nationally, 27 percent of adults under 65 have pre-existing conditions that would be deniable under short-term plans. In West Virginia, the rates are even higher. Thirty-six percent of adults under 65 have declinable chronic conditions which could range from back pain to pregnancy to a history of cancer. And even among those of us who are healthy right now, we are all just one doctor’s visit away from a chronic diagnosis.

In a state with such high chronic disease rates and at the epicenter of the opioid epidemic, skimpy plans are not what the doctor ordered. Health coverage costs can be brought under control without lowering the quality of plans available.

States like Alaska have introduced reinsurance programs, where the government helps to cover the costs of the highest-cost diagnoses rather than spreading the cost around to everyone’s premiums. New Mexico is working on a plan to allow their residents to buy into Medicaid, which would increase competition and availability of plans.

Other states have implemented price transparency and prescription negotiating regulations to bring down drug prices. All of these measures would improve affordability and access to health coverage without reducing quality.

Our lawmakers should fight for the same goals.

Kelly Allen is the outreach coordinator for the West Virginia Center on Budget and Policy.

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