Health care groups suing, again. This time nix short-term plan expansion.
As of September 17th, a total of seven industry and advocacy groups are challenging new regulations on the grounds that it violates the intent of the ACA to make low-cost insurance available to Americans. Will that challenge be able to hold up in court? What are the arguments for healthy Americans paying the cost for the very sick, whom can’t afford their own exspenses.
Short-term plans are considerably cheaper than those operating under ACA requirements because they don’t have to cover the ACA’s 10 essential benefit categories.
Seven health care industry and advocacy groups have brought suit against the Trump administration to keep short-term health plans from being expanded.
Modern Healthcare reports groups are challenging the rule from the administration that would expand the availability of short-term plans. These plans do not comply with the Affordable Care Act—on the grounds that the rule violates the intend of the ACA to make “low-cost comprehensive insurance available”.
This is the most recent lawsuit against actions taken by the administration to cut back on ACA coverage rules and insurance expansion. According to Modern Healthcare, other court actions would “halt the implementation of Medicaid work requirements, stop the expansion of association health plans, preserve contraceptive coverage, and overturn actions denying cost-sharing and risk-corridor payments to insurers.”
In a statement, a Centers for Medicare and Medicaid spokeswoman said the short-term plans “are an important option for people in certain circumstances and the Trump administration is committed to delivering greater access to more affordable choices to the men and women left out by Obamacare.”
The rule, which would take effect on October 2, would let people buy short-term plans that only last 364 days. It also would let insurers renew plans for up to 36 months. The plans are cheaper than those operating under ACA requirements because they don’t have to cover the ACA’s 10 essential benefit categories. Those include: Mental healthcare, maternity care and prescription drugs. They also may deny customers coverage because of preexisting conditions or charge higher prices based on age, heath status and gender and without caps on out-of-pocket expenses. Some look back periods are for only a little as a year for policies, so even those who have been sick in the past and think they are disqualified may be surprised.
The seven groups challenge the rule that would transform the ACA’s narrow exemption for short-term plans.
“into a loophole that would permit the creation of a parallel individual insurance market consisting of
plans that are not subject to the ACA’s consumer protection standards.
This result cannot be reconciled with the text, structure, or purpose of the ACA.”
Also stated that neither Health and Human Services, the Department of Labor nor the Treasury Department have provided any “well-reasoned justification” to eliminate the ACA’s 2016 rule that limited short-term plans to three months, from the previous limit of 364 days. In addition, the suit alleges that those agencies failed to disclose when the new rule was proposed that they intended to let short-term plans be renewed at all, much less for 36 months.
Abbe Gluck, a health law professor at Yale University who supports the ACA, told Modern Healthcare that the new rule’s proposed changes and extensions to short-term insurance are “not a reasonable interpretation of the law.”
The fear that so many consumers will switch to the cheaper short-term plans that the stability of the ACA marketplace will be threatened, with premiums being driven up as only older and sicker consumers remain, can you really blame them? But additional challenges to Trump administration changes to the law await.
Americans are seeing a turn on the table.“What we saw throughout the Obama administration was dozens of lawsuits filed by right-wing groups trying to eviscerate the ACA,” Tim Jost, an emeritus law professor at Washington and Lee University who supports the law, said. “Now things have flipped. There will be a new lawsuit every time the Trump administration does something to undermine the ACA. He keeps saying he’s trying to destroy it. It’s not surprising people are taking him seriously.”