ACA Update March 9, 2018 | HHS Says 'Not Quite' to Idaho's Illegal Health Plans, Supports Expansion of Skinny Short-Term Coverage - NCCS - National Coalition for Cancer Survivorship

Prior to the Affordable Care Act (ACA), cancer survivors were at the mercy of the health care system, often forced to pay exorbitant premiums or simply denied coverage altogether. Today, America’s 16 million cancer survivors benefit from the ACA’s patient protections that are critical to providing them with quality, affordable, and accessible health care coverage. NCCS is actively engaged in advocating to ensure this unprecedented access for cancer patients and providers continues.

As we reported recently, Idaho regulators announced they would allow the sale of insurance plans that don’t adhere to the Affordable Care Act’s (ACA) requirements and patient protections. Blue Cross of Idaho was planning to sell insurance plans that are priced based on applicants’ health status.

As health experts have pointed out, if these short-term plans are renewable, they are basically the same as pre-ACA plans that did not have to include critical services like prescription drugs, hospital visits or trips to the ER.

But in a decision announced in a letter to Idaho’s governor yesterday, the Centers for Medicare and Medicaid (CMS) said that the administration will enforce the ACA and told insurers and state regulators in Idaho that they cannot proceed with their efforts to sell plans that don’t comply with the ACA’s key requirements. “The ACA remains the law and we have a duty to enforce and uphold the law,” CMS administrator Seema Verma said in her letter to state officials.

However, in the letter she provided some further clarification, saying: “We believe that, with certain modifications, these state-based plans could be legally offered [as] short-term, limited-duration plans. I encourage you to continue to engage in a dialogue with my staff regarding this and other potential options.”

The Department of Health and Human Services already said that consumers can keep bare-bones, short-term health plans for up to a year. HHS secretary Alex Azar told reporters yesterday that HHS also wants consumers to be able to renew those plans for more than one year. As health experts have pointed out, if these short-term plans are renewable, they are basically the same as pre-ACA plans that did not have to include critical services like prescription drugs, hospital visits or trips to the ER. Additionally, allowing guaranteed renewal for short-term plans would NOT protect consumers from premium increases. Enrollees can and will be charged more if they get sick after they enroll.

Larry Levitt of Kaiser Family Foundation sums it up well: “The federal government is reining in Idaho, preventing it from allowing insurance plans that don’t comply with the ACA. But, it strongly suggests the state may be able to accomplish the same thing using ‘short-term’ plans as a vehicle.”

Another development surrounding short-term plans and the ACA is a new bill introduced by Senator John Barrasso (R-WY) that would move the individual market another step further towards having separate, parallel marketplaces for sick and healthy people. A legislative push – which appears to be backed by some in the White House – would allow short-term plans to both be available for up to a year and to have guaranteed renewability.

What the bill does, according to Axios:

Redefines short-term plans as lasting up to 364 days, which the administration has already proposed.
Gives applicants the option of selecting plans with “guaranteed renewability,” which means that the plan wouldn’t be allowed to drop the enrollee at the end of the coverage period. Of course, it could still raise premiums, especially if the enrollee became more expensive to cover.

“I assume the idea is that short-term plans become more attractive to consumers if renewable. They essentially just become skinny plans that can be renewed for multiple terms,” said Tim Jost, a law professor emeritus at Washington and Lee.

These are incredibly concerning developments, especially for the millions of cancer survivors who depend on access to affordable, quality health care. NCCS is continuing to monitor these actions and finding ways to highlight the needs of survivors in this debate.

If you would like to get involved, please contact our Public Policy Manager, Lindsay Houff, lhouff@canceradvocacy.org.

https://canceradvocacy.org/blog/aca-update-feb-16-2018/

https://canceradvocacy.org/blog/wcoe-feb-23-2018/