Commentary, Trump Administration

Comments due Monday on Trump’s scheme to bring back health plan bars to pre-existing conditions

While last year’s legislative repeal-and-replace proposals were rejected resoundingly by the American public and by a slim majority in the Senate, the Trump administration has been moving on its own to implement changes to the current health care landscape. The latest proposal from the administration would enable insurers to sell “short-term” health insurance policies that last up to 364 days—hardly a short term under any reasonable interpretation when traditional health insurance policies last 365 days. While these plans are currently on the market, they can last no more than three months under rules put in place by the Obama administration.

The Trump administration touts these plans as a solution to the country’s high health care costs. But these plans have cheap premiums because they can cherry pick whom they will cover. Upon closer examination, these plans look an awful lot like those that left millions uninsured and drowned others in medical debt before the passage of the Affordable Care Act. Here are some excerpts from a policy currently sold here in North Carolina by Golden Rule Insurance Company, which is a UnitedHealthcare company:

Preexisting conditions, and complications resulting from a preexisting condition, will not be covered under the policy.

Preexisting condition means those conditions for which medical advice, diagnosis, care or treatment was received or recommended, or a condition that had manifested itself, within the one-year period immediately preceding the effective date of a person’s coverage; or a pregnancy existing on the effective date of coverage.

Another reason that premiums are low for these plans is that you get what you pay for. These policies cover so few benefits and pay out so little in claims that insurance companies selling them actually reap much greater profits than on traditional plans. Short term plans routinely exclude benefits not just for coverage of pre-existing conditions, but also for essential services like prescription drugs, mental health and substance use disorder treatment, pregnancy care, and preventive care, among a host of others.

Even for the few services that are covered, enrollees will be stuck with large out-of-pocket bills. Some Golden Rule policies on the market have deductibles of up to $12,500 for a policy that lasts only three months, and some of these policies also impose dollar limits on what they’ll pay out in benefits over an enrollee’s lifetime or policy period. One Golden Rule policy in NC includes a $250,000 lifetime limit.

And that’s the trend: insurers make bank off of these policies while enrollees attracted by the low premium find themselves without adequate coverage and face-to-face with crushing medical debt once they need care.

These plans are dangerous to those who enroll in them. But they also undermine the ACA and those who benefit from comprehensive coverage there. Through their discriminatory premiums and benefit designs, short-term plans are designed to pull young and healthy folks out of the ACA coverage market, leaving the remaining risk pool older, sicker, and more expensive. This puts comprehensive coverage out of reach, especially for North Carolinians who make too much to qualify for premium subsidies under the law.

Unlike last year when the GOP-controlled Congress failed to revive these discriminatory plans through legislation, the Trump administration is proposing to do this through administrative rulemaking, meaning that members of the public can weigh in by submitting comments until the deadline on Monday, April 23. Click here to submit your own comment.

One Comment


  1. Rick Reddel

    April 22, 2018 at 8:29 am

    Don’t forget that Insurance is a for profit industry – just drive by the houses of those that sell insurance and will see how profitable that industry is. Also don’t forget that before Obama Care Insurance was a Choice – millions of Americans Chose not to take on Insurance coverage and roll the dice to save some money or use their money for other things. Obama Care didn’t help either. The government would have saved money had they given coverage to the people who they were targeting rather than spend nearly $1 billion (probably more by now) on the software application to support it.

    Like so many other industries have done, the Health insurance industry needs to be be disrupted – not by government but by innovation and free markets). Addressing this will make the biggest impact on healthcare.

Check Also

Skimpy health insurance plans & pre-existing conditions are back under new Trump rule

Today the Trump administration issued a final rule ...

Top Stories from NCPW

  • News
  • Commentary

Breaking the Republicans’ veto-proof majority was the Democrats’ and voting rights activists’ short [...]

The Joint Subcommittee on the Atlantic Coast Pipeline voted Wednesday to launch an investigation int [...]

North Carolina is not the only state whose transgender state employees and dependents are without in [...]

As LGBTQ state employees and dependents struggle to restore State Health Plan coverage for transgend [...]

Despite the manufactured panic of the migrant caravan, despite the midterm’s so-called “referendum o [...]

The 2018 election may finally be in the rear view mirror, but for better or worse, the next battle o [...]

The first thing Gov. Roy Cooper did after he reported for work on Wednesday, Nov. 7, was to order up [...]

The post The GOP’s Supermajority appeared first on NC Policy Watch. [...]