Opinion

New Administration-Backed Health Plan Presents Risks for Those Who Need Help

People need access to comprehensive health care coverage at a price they can afford. But an anticipated regulatory action by the administration will have the opposite effect.

It will again allow the further extension of the sale of skimpy health policies that will attract only the healthiest people, raising costs for those who need or want comprehensive benefits to protect their families. Even people who were healthy when they purchased these types of plans could find they are without meaningful coverage when they get sick or need essential medical care — like maternity care, access to emergency room services or prescription drug coverage — that isn’t covered or whose coverage is limited.

We — patient advocates, physicians, hospitals and insurers — are united in our deep concerns with this proposal. A recent review by the Los Angeles Times revealed that more than 95 percent of the health care organizations that commented on the proposed regulatory changes expressed concern or outright opposition. Indeed, protections in current law for those with pre-existing conditions are broadly supported by the public and by members of Congress on both sides of the aisle.

Under the administration’s proposal, consumers could obtain short-term plans that would last nearly twelve months instead of the current three months. These plans are not required to provide comprehensive coverage for essential health benefits, can have lifetime and annual dollar limits and can deny or charge higher rates for people based on their health status, gender and age.

Those Americans who are drawn into short-term plans could find their coverage inadequate with very high out-of-pocket costs — especially if they get sick. If you’re not in perfect health, it is likely that these plans aren’t even an option for you.

It’s completely understandable why the low-cost price tag on these plans would attract consumers, especially younger, healthier individuals and those whose incomes do not qualify them for financial help with their premiums. But allowing younger, healthier individuals to take up these plans will raise premiums for those who rely on more comprehensive coverage to care for themselves and their families. According to the Centers for Medicare and Medicaid Services Actuary, the proposal would cause premiums to increase for people who purchase individual coverage and who don’t get financial assistance.

Numerous public opinion polls have shown that the issue people most care about in health care is making coverage more affordable. For that, short-term plans are not the answer.

Instead, we believe lawmakers should focus on making comprehensive, affordable coverage available to everyone, regardless of pre-existing conditions, with broad-based funding to help manage the highest-cost individuals. Only then can we focus on managing chronic conditions, which account for 86 cents of every health care dollar, and on lowering premiums for everyone.  

Key protections — such as equal rates for women and men, no lifetime caps on benefits and allowing young people to stay on their parents’ plans until age 26 — must also be preserved.

Finally, states should be empowered to meet the unique needs of their communities. They are in the best position to understand and respond to their local health care systems and citizens’ needs. Many states are looking at ways to protect consumers from harm as a result of the administration’s proposal. Others are seeking ways to lower premiums through federal waivers. The administration should prioritize approving proposals that help consumers.  

When lawmakers focus on providing access to quality, affordable insurance, it will improve patient outcomes and allow Americans to stay healthy and remain financially secure.

 

Mark Schoeberl is executive vice president of advocacy at the American Heart Association; Tom Nickels is executive vice president of government relations and public policy at the American Hospital Association; Richard Deem is senior vice president of advocacy at the American Medical Association; and Justine Handelman is senior vice president of the Office of Policy and Representation for the Blue Cross Blue Shield Association.

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