Several healthcare advocacy organizations are coming out in support of the White House’s final rule announced last week that targets short-term health plans, or “junk” insurance plans.
“The American Medical Association (AMA) deeply appreciates the Biden administration’s final rule … protecting consumers from low-quality health coverage by cracking down on junk insurance. These short-term policies are often marketed and sold in a misleading and deceptive manner, leading consumers to confuse them for comprehensive insurance,” said Dr. Jesse Ehrenfeld, president of the AMA, in a statement.
Short-term, limited-duration insurance plans are meant to support consumers while they’re transitioning from one form of coverage to another. However, they’re not required to follow the Affordable Care Act’s consumer protections, such as guaranteeing coverage for people with pre-existing conditions. These plans were previously limited to three months by the Obama administration, but the Trump administration allowed members to stay on the plans for 12 months and renew them for three years.
“These ‘junk insurance’ plans leave families surprised by thousands of dollars in bills, often because the insurance plan claims they have a pre-existing condition that isn’t covered,” the White House said in a fact sheet. “For example, a man in Montana faced $43,000 in health care costs because his insurance plan claimed his cancer was a pre-existing condition, and a Pennsylvania woman was surprised by nearly $20,000 in bills for an amputation her junk plan refused to cover.”
Under the final rule, short-term plans “must be truly short-term,” the fact sheet stated. These plans are limited to no more than four months. In addition, plans are required to provide a disclaimer that clearly describes the limits of their coverage.
Ehrenfeld said the changes “will lessen risks to consumers, promote transparency, expand patient protections, and help to stabilize the market.” He added that while short-term, limited duration health plans are less costly, they provide fewer benefits and use marketing tactics that “trick people into buying health plans that discriminate based on pre-existing conditions while providing little or no coverage.”
Margaret A. Murray, CEO of the Association for Community Affiliated Plans (ACAP), echoed Ehrenfeld’s comments.
“Short-term, limited-duration insurance and other non-ACA-compliant plans may offer consumers low premiums, but that comes with a false sense of security and skimpy or even non-existent coverage. … This new regulation that returns short-term, limited-duration insurance plans to their original purpose as stopgap coverage is a win for consumers,” Murray said in a statement. “Improved consumer disclosures will also better inform people about the limitations of these policies and help protect consumers from selecting products that don’t cover the health care services they expect and may well need.”
A group of 35 patient organizations also came out in support of the final rule. The organizations include the American Diabetes Association, the American Heart Association and March of Dimes.
“The new rule will ensure that short-term health plans are used as they were originally intended: as short-term, stop-gap coverage while consumers are between other plans. … We expect the new rule to improve clarity for consumers and provide greater assurance about the quality of the health coverage they purchase,” the organizations said in a joint statement.
Photo: Oleksandr Hruts, Getty Images
Marissa Plescia is a reporter for MedCity News covering payers, employers and health tech. She previously worked at Becker’s Hospital Review as a finance reporter. Before that, she was a data journalism intern at Kansas City PBS for the Dow Jones News Fund. She received her Master of Science and Bachelor of Science in journalism at the University of Illinois Urbana-Champaign.
