You don’t have to be low-income or uninsured to grasp how challenging and complex the modern world of health care and health insurance has become. Even in my role as a fully insured professional who works in the field every day as an advocate, I wrestle with the challenges the system presents — especially when I grapple with the health concerns of my teenage children and retired parents. The Affordable Care Act has certainly improved things, but we clearly have a long way to go.
In such an environment — one that challenges even informed and comparatively well-off people — it’s remarkable and outrageous that the Trump administration released a proposed health care rule yesterday that would make it harder to for people to remain covered. This proposal — which comes just one day after many North Carolinians celebrated the value of Affordable Care Act at various #HaveAHeart events throughout the state — shows that opponents of the ACA in Congress and the Trump administration value the short-term bottom lines of insurance companies over citizens that elected them into office.
The proposed rule would increase premiums and out-of-pocket costs for consumers while reducing financial help (i.e. tax credits) and plan offerings. It would also shrink the open enrollment period from three months to less than two — a change favored by some insurance companies which complain that people sometimes enroll toward the end of open enrollment period to pay for upcoming costly services only to drop coverage soon after. Instead of viewing the late sign-up as an economic issue for consumers, it seems insurers and the Trump administration believe there are people who actually plan in advance to develop a health condition, suffer a trauma or even receive news of a serious diagnosis after a preventive screening only to drop it and not continue future care.
Another provision on the table provides that regardless of health status, insurers can decide to refuse coverage to individuals or employers who have unpaid premiums. Such a policy would be sure to produce devastating effects in the form of delayed care and worse health outcomes (even death) for families dealing with significant economic and medical needs. It would also increase long-run costs as earlier, lower-cost interventions give way to later, higher-cost treatments. Sadly, the Trump administration seems determined to address the concerns of the insurance industry by shifting all of the burden onto the backs of millions of average Americans.
It shouldn’t (and doesn’t have) to be this way. Instead of higher costs and greater uncertainty, Americans should instead be assured they can have health coverage to access the care they need, when they need it, free from discrimination. Insurers should have a place in a stable, strong Market free from provisions that encourage collapse. What’s more, insurance companies should do what they usually do best — look at the long term — and join with consumers to push for such a win-win outcome.
Right now, individuals, providers, public officials and other leaders across the country are pushing back against the Trump proposals. Let’s hope insurance companies — many of which are among the leading corporate citizens in North Carolina and elsewhere — begin to look beyond their own narrow, short-term interests and join in this effort.