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Trump administration moves to further expand skimpy health plans

Trump administration moves to further expand skimpy health plans
A young cancer patient reaches for his father at Comer Children's Hospital at the University of Chicago. Scores of patient advocacy groups say the Trump administration's moves to relax insurance rules will harm sick patients. (McClatchy/Tribune)

The Trump administration took another step Wednesday to loosen regulation of health insurance, issuing new regulations to expand the availability of short-term plans that don’t offer a full set of benefits.

The controversial move — which threatens to further weaken a pillar of the Affordable Care Act — will allow consumers who buy skimpier short-term plans to keep the coverage for as long as three years, up from the current limit of three months.

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The president and others in the administration bill the less comprehensive plans as a solution to escalating premiums facing some consumers who don’t get health coverage through an employer or a government health program such as Medicare or Medicaid

“These plans aren’t for everyone, but they can provide a much more affordable option for millions of the forgotten men and women left out by the current system,” said Health and Human Services Secretary Alex Azar.

But scores of patient advocacy organizations, leading physician and hospital groups, health insurers and many state regulators have vigorously opposed the administration’s move, warning that skimpier plans, while possibly less costly, may not provide consumers with the coverage they need if they get sick.

Expanding short-term plans also risks driving up costs for Americans with preexisting medical conditions who need more comprehensive benefits.

A central goal of the 2010 healthcare law, often called Obamacare, was to guarantee coverage to Americans even if they were sick, and end the longstanding practice by health insurers of charging higher premiums to consumers with preexisting conditions. An important tool in assuring equal treatment for all consumers was mandating that health plans cover a basic set of benefits, including prescription drugs, mental health services and maternity care.

Most patient advocates believe short-term plans undermine those key protections.

“Short-term plans … will not offer sufficient healthcare coverage for those living with a lung disease such as asthma, lung cancer or COPD [chronic obstructive pulmonary disease],” warned American Lung Assn. National President Harold P. Wimmer. “This is a reckless course of action that will negatively impact the health of patients around the country.”

The criticism was echoed by America’s Health Insurance Plans, the industry’s Washington-based lobbying arm.

“We remain concerned that consumers who rely on short-term plans for an extended time period will face high medical bills when they need care that isn’t covered or exceed their coverage limits,” said Matt Eyles, the group’s president.

A Los Angeles Times analysis of official comments filed with federal agencies before the final regulation was issued found more than 98% — or 335 of 340 — of the healthcare groups that commented on the proposal criticized it, in many cases warning that the rule could gravely hurt sick patients.

A second Trump administration proposal to make it easier for individuals and small businesses to band together to form so-called association health plans — which also don’t have offer a full set of health benefits — was similarly panned. More than 95% of the 279 healthcare groups that filed comments about the proposed association health plan regulation expressed serious concern or opposed it.

Among the groups that have opposed the Trump administration’s moves are virtually every leading patient advocacy organization in the country, including the American Lung Assn., the American Heart Assn., the Cystic Fibrosis Foundation, the March of Dimes, the National Multiple Sclerosis Society, Susan G. Komen, AARP and the advocacy arm of the American Cancer Society.

Administration officials appeared to give a nod to critics’ concerns that the short-term plans could leave consumers without critical protections.

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The new regulation requires plans to more clearly alert consumers to limits on the coverage they provide, and appears to give states authority to restrict their availability.

State insurance regulators in many states, including California, Washington, Nevada, Minnesota, Massachusetts, Pennsylvania and New Mexico, have expressed serious concerns about expanding short-term plans.

Several of these states, including California, are already suing the Trump administration to roll back the new association health plan rule.

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