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Junk Plans Archives — Protect Our Care

Today in Health Care Sabotage: Administration Shifts Millions Away From Health Care Services…and Toward Child Detention

Health and Human Services Secretary Alex Azar Undermines Health Care in Decision to Shift Funds Away from Health Care Services

Washington, D.C. – In its latest act of health care sabotage and in support of its cruel immigration policy, HHS Secretary Azar is shifting nearly half a billion dollars away from medical research, HIV/AIDS treatment and Affordable Care Act implementation toward detention of migrant children. Leslie Dach, chair of Protect Our Care, released the following statement in response:

“This is more than just health care sabotage, this is health care sabotage committed for the purpose of keeping children and families apart. It is shameful and outright wrong. Azar is only the latest Republican to play a dangerous game with the individuals who need health care the most.”

California is the Latest State to Fight Trump’s Expansion of Junk Plans

While The Trump Administration and Republicans in Congress Push Junk Plans, States Join Health Care Advocates and Congressional Democrats in Fighting Back

 

Washington, D.C. –  While the Trump Administration continues its efforts to attack people with pre-existing conditions and sabotage health care through the expansion of junk insurance plans  — and Republicans in Congress refuse to join their Democratic colleagues in the Senate and House in stopping them — the state of California joins other states in protecting its residents from dangerous ‘junk’ plans through new legislation signed into law Saturday.

Going one step further in its rebuke of the Trump Administration’s disastrous health care policies, California also enacted new legislation protecting Californians against the Trump Administration’s scheme to reduce Medicaid coverage by imposing rigid work requirements. This is a win for health care, as these work requirements have proven to be impossible for many of those most in need of health care coverage to meet.

Brad Woodhouse, executive director of Protect Our Care issued the following statement in response to the growing fight against junk plans:

“While Trump and his Republican allies take a sledgehammer to health care, it becomes even more important that states like California and others step up and protect our care, which is exactly what the American people want our leaders to do. The reasons that officials are fighting Trump’s junk plans in the states, that health care advocates are fighting them in court, that Democratic health care champions in Congress are fighting them on the Hill are simple: these junk plans are allowed to deny coverage to people with pre-existing conditions, they are not required to cover key benefits, such as cancer treatments and prescription drug coverage, and they deceive consumers by refusing to pay for costs after a person gets sick. Since these insurance plans truly are ‘junk’ and have a long history of scamming people who need health care coverage the most the real question is why Donald Trump thinks he can call himself a protector of people with pre-existing conditions at the same time that he and his allies in Washington are pushing junk plans onto the American people?”

 

Insurance Commissioners From Coast to Coast Have Spoken Out Against Short-Term Junk Plans:

Dave Jones, California Insurance Commissioner: “Of Course They’ll Be Less Expensive…That’s Because It’s Junk Insurance And It Won’t Cover The Same Things.” [HuffPost, 8/5/18]

Jessica Altman, PA Insurance Commissioner: The Administration Isn’t Talking About How Limited These Plans Are. “I’m frustrated with how [administration officials] are presenting this…They’re saying, ‘Here’s this option that’s affordable and wonderful,’ and not talking about how limited the plans are…You can look at one of these plans and you’ll see it covers doctors, hospitals, maybe even drugs, and so you think it will have everything I need…You won’t realize that the amounts are caps, or have exclusions ― it’s really difficult to expect that consumers will be able to figure out what all of this means, and really know what they are getting.” [HuffPost, 8/5/18]

PA Insurance Commissioner Jessica Altman Has Already Revoked The Licenses Of Eight Brokers Or Agents Misrepresenting Short-term Plans. “In Pennsylvania, Altman said she has already revoked the licenses of eight brokers or agents who had been misrepresenting short-term plans.” [The Hill, 8/12/18]

TN Insurance Commissioner, Julie Mix McPeak Is Concerned About Whether Consumers Fully Understand The Plans They Buy. “‘We have to really make sure consumers know what they’re purchasing, and they’re aware of what’s covered and what’s not covered,’ Mix McPeak said. ‘The last thing we need is for consumers to have surprise bills.'” [The Hill, 8/12/18]

Lori Wing-Heier, Director Of Alaska Insurance Division: “I’m Concerned That People Will Buy These Policies, Show Up At The Hospital For A Condition They Did Not Expect, And Discover They Are Not Covered.” [HuffPost, 8/5/18]

Lori Wing-Heier, Director Of Alaska Insurance Division: Under Short-Term Plans, Insurers May Use Information You Submit In Good Faith To Deny Coverage. “You fill out the form, the medical forms, you think you are being honest about your history, and then the insurers go through your records and find something that you didn’t think was an issue, your doctor didn’t think was an issue, but now the insurer is saying it’s a pre-existing condition.” [HuffPost, 8/5/18]

Michael Conway, Colorado Interim Insurance Commissioner: People May Read Warnings, But Not Understand How Bare-bones These Plans Really Are. “They may read [the warning], but that’s not the same as understanding it…Because of the ACA, now people think the baseline has changed ― that certain things are always covered.” [HuffPost, 8/5/18]

Troy Oechsner, Deputy Superintendent At New York Department Of Financial Services: “These Are Substandard Products.” “‘These are substandard products,’ sold on the premise that ‘junk insurance is better than nothing’ for people who cannot afford comprehensive coverage, Troy J. Oechsner, a deputy superintendent at the New York Department of Financial Services, told the insurers.” [New York Times, 8/6/18]

View Protect Our Care’s factsheets on short term junk plans and association junk plans for more information.

 

Advocates, Elected Officials Fight Trump’s Junk Plans on All Fronts

New Lawsuit Filed by Health Care Organizations Seeks to Invalidate Trump’s Harmful Junk Plan Rule

New House Resolution, Mirroring One in the Senate, Would Override The Trump Administration’s Rule To Stop Junk Plans

Washington, D.C. – On the heels of the Trump Administration expanding junk plans that can deny coverage to people with pre-existing conditions, that are not required to cover key benefits, such as cancer treatments and prescription drug coverage, and that can refuse to pay for costs after a person gets sick, health care advocates and Democrats in Congress are fighting back.

Today, the Association for Community Affiliated Plans (ACAP), National Alliance on Mental Illness (NAMI), Mental Health America, American Psychiatric Association (APA), AIDS United, National Partnership for Women & Families, and Little Lobbyists filed suit in the U.S. District Court for the District of Columbia to invalidate the Trump Administration’s short-term junk plan rule issued last month. This lawsuit comes just after Congresswoman Kathy Castor (D-FL-14) introduced a resolution that would override the Trump Administration’s rule to allow insurance companies to sell junk plans that charge people more money for less care. The Senate has a companion resolution that is awaiting any Republican support.

Brad Woodhouse, executive director of Protect Our Care issued the following statement in response to the multi-front fight against junk plans:

“The Trump Administration’s never-ending war on health care is not going unanswered. It is facing resistance on the Hill, resistance in the courts and — as poll after poll shows — resistance from the public. House and Senate Democrats have entered the arena to fight for hard-working Americans. Now, it’s time for Republicans to join them.”

House Republicans Who Claim to Support Pre-existing Conditions Protections Should Prove It and Join Castor’s Resolution:

Rep. Martha McSally (R-AZ): “Rep. McSally Is Committed To Ensuring That Individuals With Pre-Existing Conditions Have Access To Affordable Coverage Options And Cannot Be Denied Health Insurance.” “Rep. McSally is committed to ensuring that individuals with pre-existing conditions have access to affordable coverage options and cannot be denied health insurance. She will work to ensure the House reform package includes these protections.” [Tucson Weekly Dispatch, 3/1/17]

Rep. Carlos Curbelo (R-FL): “We’re Keeping The Things That Work, Like Guaranteed Coverage For Pre-Existing Conditions.” “We’re keeping the things that work, like guaranteed coverage for pre-existing conditions, allowing young people to remain on their parents’ plans until the age of 26, and prohibiting discrimination against women.” [Sunshine State News, 3/11/17]

Rep. Brian Mast (R-FL): “We Also Need To Ensure That Patients With Pre-Existing Conditions Won’t Be Denied Coverage.” “We also need to ensure that patients with pre-existing conditions won’t be denied coverage and that those who rely on Medicaid have access to quality care.” [Palm Beach Post, 3/9/17]

Rep. Bruce Poliquin (R-ME): Rep. Poliquin Would Only Support A Repeal Of The ACA If The Replacement Includes Coverage For Pre-Existing Conditions.” “Poliquin would support a repeal of the Affordable Care Act, but only if the alternative plan includes coverage for pre-existing conditions, allows young adults to remain on their parents’ plans until the age of 26, and doesn’t immediately end Obamacare exchange policies.” [WABI TV5, 1/24/17]

Rep. Erik Paulsen (R-MN): “Rep. [Erik] Paulsen has long supported protections for individuals with pre-existing conditions, and he continues to do so,” a spokesman for Paulsen, the Republican representing Minnesota’s Third Congressional District, said in a statement. [Star Tribune, 6/23/18]

Rep. John Culberson (R-TX): “Health Care Should Be Accessible For All, Regardless Of Pre-Existing Conditions Or Past Illnesses.” [Rep. Culberson Website Content Current as of 4/20/17]

Rep. Dave Brat (R-VA): Rep. Brat Stresses Care Would Continue For Those With Pre-Existing Conditions.” “He calmed nerves, for some, by stressing care would continue for those with preexisting conditions.” [CBS WTVR 6 News, 2/21/17]

Rep. Scott Taylor (R-VA): “We Will Protect Those With Pre-Existing Conditions.” “We will protect those with preexisting conditions, we will work help those who can’t help themselves, work to get more access and more people covered.” [Republican Party of Virginia, 3/10/17]

 

Protect Our Care Calls on Senate Republicans to Support Sen. Baldwin’s Resolution and Protect People with Pre-Existing Conditions

Resolution’s Passage Would Stop Junk Plans and Protect Americans With Pre-Existing Conditions

Washington, D.C. – Senator Tammy Baldwin (D-WI) has garnered enough support to force a vote on her resolution to block insurers from selling the Trump Administration’s short-term, junk insurance plans, with 45 Senators signing onto the bill. Now, Brad Woodhouse, executive director of Protect Our Care, calls on the full Senate to support and pass this bill, which is supported by over a dozen health care and patient advocacy groups.:

“By gathering enormous support for this resolution, Senator Baldwin and her colleagues are once again showing the American people who is fighting for them. Now it’s time for Senate Republicans who all of the sudden claim to be protectors of people with pre-existing conditions to put up or shut up. If the GOP truly cared about protecting Americans with pre-existing conditions, they would join their colleagues on this resolution in taking concrete action to preserve the protections and essential health benefits that tens of millions of Americans depend on — and they would do so immediately. Republicans’ silence on this resolution is complicity in Trump’s assault on people with pre-existing conditions through the promotion of junk insurance plans.”

 

ADDITIONAL BACKGROUND

Right Now, The GOP is Actively Pushing A Bill to Weaken Pre-existing Conditions Protections

  • Twenty-eight Patient Groups – Including the American Cancer Society Cancer Action Network, American Heart Association, March of Dimes – Oppose the GOP Senate Bill. Writing in opposition to the bill, the groups explain, “it would not ban pre-existing condition exclusions and would remove rating restrictions based on age, gender, tobacco use, or occupation. This means that many individuals could still face higher premiums and out-of-pocket costs and, even if enrollees paid the increased premiums for many months, they could still be denied benefits because of a pre-existing condition. In short, this bill would not replace critical protections in current law.”
  • Americans Could Be On The Hook For Tens Of Thousands Of Dollars Should Existing Pre-Existing Conditions Laws Be Replaced With Those Proposed By Republicans. According to a report in Vox, “An easy illustration: CMS says that lung cancer costs roughly 12 times as much as the average premiums. So if the average premium is $1,000 per month, then lung cancer treatment costs about $12,000 every month. Sickle-cell anemia is eight times the average premium. So is multiple sclerosis. Cystic fibrosis treatment is expected to cost $14,000 if the average premium is $1,000. Those numbers are hypothetical, to be clear, but you get the idea. Americans could be on the hook for tens of thousands of dollars if their health insurance no longer has to cover their preexisting conditions.”

GOP Senators Have Also Refused to Defend Pre-existing Conditions from the Trump-GOP Lawsuit

  • Not One GOP Senator Has Signed On To Sen. Manchin’s Resolution That Would Allow The Senate To Defend Pre-existing Condition Protections In Court. This summer, the Trump Administration refused to defend against  a lawsuit brought by twenty conservative states aimed at overturning the Affordable Care Act and its protections for people with pre-existing conditions. Last month, Senate Democrats introduced a resolution that would authorize the Senate Legal Counsel to intervene in the lawsuit and defend protections for people with pre-existing conditions. Senator Collins refuses to support the resolution.

Short-term Plans Hurt People with Pre-existing Conditions

Short-Term Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • One in 4 Children Would Be Impacted If Insurance Companies Could Deny Coverage Or Charge More Because Of A Pre-existing Condition. [Center for American Progress, 4/5/17]

Junk Plans Mean Higher Premiums For People With Pre-Existing Conditions. By promoting short-term policies, the administration is making a trade-off: lower premiums and less coverage for healthy people, and higher premiums for people with preexisting conditions who need more comprehensive coverage.” [Washington Post, 5/1/18]

Short-Term Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Under Many Short-Term Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

For more information, see Protect Our Care’s fact sheet on short-term junk plans.

Trump Administration Sabotages Open Enrollment, Pushes Junk Plans, Attacks Assistance for Navigators Yet Again

Washington, D.C. – This afternoon, the Trump Administration announced that it was slashing navigator funding designed to designed to help Americans obtain coverage by 84 percent and pushing enrollment for junk plans that charge people more money for less care and can deny coverage to people with pre-existing conditions. Brad Woodhouse, executive director of Protect Our Care, released the following statement in response:

“Last year, the Trump Administration cut the open enrollment period in half and slashed advertising by ninety percent. Now the Administration is once again doubling down on their sabotage of American health care by coupling further drastic cuts to the individuals who help Americans enroll with a cynical attempt to push Americans into junk plans which can deny coverage to those with pre-existing conditions. Yet again the Trump Administration is taking active steps to harm health care, and yet again it is the American people who will be left to suffer.”

BACKGROUND:

Junk Plans May Exclude Coverage For Pre-Existing Conditions. “Policyholders who get sick may be investigated by the insurer to determine whether the newly-diagnosed condition could be considered pre-existing and so excluded from coverage.” [Kaiser Family Foundation, 2/9/18]

  • As Many As 130 Million Nonelderly Americans Have A Pre-Existing Condition. [Center for American Progress, 4/5/17]
  • 1 in 4 Children Would Be Impacted If Insurance Companies Could Deny Or Charge More Because Of A Pre-Existing Condition. [Center for American Progress, 4/5/17]

Junk Plans Can Refuse To Cover Essential Health Benefits. “Typical short-term policies do not cover maternity care, prescription drugs, mental health care, preventive care, and other essential benefits, and may limit coverage in other ways.” [Kaiser Family Foundation, 2/9/18]

Under Many Junk Plans, Benefits Are Capped At $1 Million Or Less. Short-term plans can impose lifetime and annual limits –  “for example, many policies cap covered benefits at $1 million or less.” [Kaiser Family Foundation, 2/9/18]

Trump Administration Slashes Grants To Help Americans Get Affordable Care Act Coverage. “The Trump administration has distributed $10 million in grants to 39 organizations that help people enroll in Obamacare, a drop from the 90 organizations that received the awards last year when funding was nearly three times as high. The Trump administration slashed the budget for navigators from $100 million during the final open enrollment of former President Barack Obama’s term to $36 million, and slashed it even further to $10 million this year. Democrats have called the move another instance of ‘sabotage’ against the healthcare law.” [Washington Examiner, 9/12/10]

During The First Open Enrollment Period, 10.6 Million Americans Were Assisted By Navigators. “More than 4,400 Assister Programs, employing more than 28,000 full-time-equivalent staff and volunteers, helped an estimated 10.6 million people during the first Open Enrollment period.” [Kaiser Family Foundation, 7/15/14]

For Months, The Groups That Help People Sign Up For Marketplace Coverage Have Been In Limbo. “Local groups that help people sign up for ObamaCare and Medicaid have yet to hear from the Trump administration about their annual federal funding, leaving many in limbo and fearing the grants could be too small or might not come at all…The organizations typically hear from the federal government in April or early May with information about how much money will be available for grants, when key deadlines are and the expected award date. But several navigators contacted by The Hill said they have received no information from the Centers for Medicare & Medicaid Services..When asked about the navigator grants, a spokesperson for the Department of Health and Human Services (HHS) wrote in an email that HHS did not have any details to share at this time.” [The Hill, 6/20/18]

  • Dan Derksen, Doctor Who Oversees Navigator Program At University Of Arizona: “At a time when people have more questions, it’s very likely there will be fewer people to help them in person.” [USA Today, 6/21/18]
  • Last Year’s Cuts Led University Of Florida Navigator Program To Cut Staff. “Jodi Ray, director of Florida Covering Kids & Families navigator group at the University of South Florida, said her organization is bracing for changes. Last year’s cuts forced the Florida group to trim the number of employed navigators. She worries that further cuts and program changes could harm the state’s vulnerable residents who rely on the organization’s services.” [USA Today, 6/21/18]
  • Karen Egozi, CEO Of The Epilepsy Foundation Of Florida: We’re In The Dark. “We really haven’t gotten any update or any deadline to submit applications or any knowledge at all about what the future is going to bring.” [The Hill, 6/20/18]
  • Catherine Edwards, Executive Director For The Missouri Association Of Area Agencies On Aging: Administration Has No Incentive To Work With Community Groups. “We know this administration is not friendly to the ACA, and so they have no incentive to involve community-based groups in enrolling people.” [The Hill, 6/20/18]
  • Shelli Quenga, Director Of Programs For South Carolina-Based Palmetto Project: Restricting Support Is Bad For Consumers. “It’s very unfortunate for the consumer…We know that consumers still need in-person assistance — and especially consumers who are not native English speakers, consumers who are living just above the poverty line who don’t have a lot of experience with making big financial decisions like this that also have long-term implications to their financial future for themselves and their family members.” [The Hill, 6/20/18]
  • Cutting Funds To Navigator Groups Means They Must Significantly Cut Back On Outreach. “‘We have no expectation of any federal money being available to us,’ said Donna Friedsam, the director of Covering Wisconsin, a navigator program. Her organization received a 42 percent reduction last year because of the funding changes. It previously offered enrollment services in 23 counties, but had to scale down to 12.” [The Hill, 6/20/18]
  • Trump Administration Considering Cutting Funding For Health Care Navigator Groups. “The Trump administration is considering cutting funding for ObamaCare outreach groups that help people enroll in coverage, sources say. An initial proposal by the administration would have cut the funding for the groups, known as “navigators,” from $36 million last year to $10 million this year. Sources say that proposal now could be walked back, and it is possible funding could remain the same as last year, but it is unclear where the final number will end up.” [The Hill, 6/29/18]
  • Jodi Ray, Director Of Florida Covering Kids And Families: “Less Resources Means We Have Less Boots On The Ground To Provide That Enrollment Assistance.” [The Hill, 6/29/18]

Experts Condemn Trump Move To Push Junk Short-Term Plans

This morning, the Trump Administration announced a rule that encourages consumers to ditch comprehensive health care in favor of junk short-term plans that will leave them with piles of bills and without coverage should they get sick. This announcement is just the latest attempt to undermine the Affordable Care Act, strip protections for people with pre-existing conditions, and drive up premiums. Here’s a look at what experts are saying:

Mary Dwight, Senior Vice President Of Cystic Fibrosis Foundation: Plans Will Split Market Into Plans For Healthy And Plans For Sick. “The new plans will no longer be just transition coverage. They will be an alternative to comprehensive insurance. They will split the market into plans for healthy people and plans for sick people.” [New York Times, 8/1/18]

Sabrina Corlette, Professor At Georgetown University Health Policy Institute: Short-Term Plans Are “Very Much A Buyer-Beware Situation.”  [Bloomberg, 7/31/18]

Larry Levitt, Senior Vice President of Kaiser Family Foundation: Trump Using Short-Term Plans To Create Parallel Insurance Market That Can Skirt ACA Consumer Protections. “The Trump administration cannot eliminate the ACA’s insurance rules. Instead, they are using short-term insurance plans to create a parallel market of insurance plans that do not have to follow any of the ACA’s rules.” [Levitt, 8/1/18]

Chris Hansen, President Of The American Cancer Society Cancer Action Network: People With Cancer Could “Face Astronomical Costs.” “People who buy the new policies and develop cancer could ‘face astronomical costs’ and ‘may be forced to forgo treatment entirely because of costs.'” [New York Times, 8/1/18]

Georgetown Center On Health Insurance Reforms: As Bills Start To Pile Up Under Short-Term Plans, Many Folks Would Realize “They’re Not Really Insured At All.” “If you are pregnant, you will have to find another way to pay for the cost of your pre-natal care and labor and delivery (maternity care charges for a normal birth average $32,093; $51,125 for an uncomplicated C-section). If you get cancer, your plan will not cover oncology drugs, which can cost an average of $10,000 per month. If you are hospitalized, you may find yourself owing hundreds of thousands of dollars for services that are not covered by your plan.” [Georgetown Center On Health Insurance Reforms, 7/26/18]

Blue Cross Blue Blue Shield Association: “The Broader Availability And Longer Duration Of Slimmed Down Policies That Do Not Provide Comprehensive Coverage Has The Potential To Harm Consumers.” “The broader availability and longer duration of slimmed-down policies that do not provide comprehensive coverage has the potential to  harm consumers, both by making comprehensive coverage more expensive and by leaving some consumers unaware of the risks of these policies.” [Politico, 8/1/18]

Erika Sward, Assistant Vice President Of The American Lung Association Describes Rule As “One More Blow Of An Ax To Stable State Marketplaces.” [New York Times, 8/1/18]

America’s Health Insurance Plans: We Remain Concerned That Consumers Will Face HIgh Medical Bills When They Need Care That Isn’t Covered. 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.” [Alice Ollstein, Talking Points Memo, 8/1/18]

New National Association of Insurance Commissioners Report Confirms That With Short-Term Plans, A Significantly Higher Percentage Of Money Goes Toward Administrative Costs And Profits Than Care. The NAIC report reveals that the largest seller of short-term plans, UnitedHealth, has a medical loss ratio, the ratio of money that goes toward care versus administrative costs and profits, of 43.7 percent, compared to the ACA-mandated minimum of 80 percent. [NAIC, July 2018]

Trump Administration Ignores 98 Percent of Health Experts, Greenlights Junk Insurance Plans

This is the GOP’s Fifth Act of Sabotage In the Past Week Alone

Washington, D.C. – In response to the Trump Administration’s final rule bringing short-term, junk plans back to consumers, Brad Woodhouse, executive director of Protect Our Care, released the following statement:

“Today’s announcement is nothing more than the Trump Administration’s and Republicans latest attack on our health care, taking its summer of sabotage to a new level and once again leaving Americans holding the bill. Coming on the heels of the GOP pushing forward a lawsuit to end the protections Americans depend upon under the Affordable Care Act, including those for the 130 million people with pre-existing conditions, this rule will let insurance companies with billions in profits once again take Americans’ hard-earned money while drastically limiting coverage. Short term junk plans don’t cover people with pre-existing conditions, don’t include coverage for basic medical needs like prescription drugs, and refuse to pay benefits when a legitimate medical emergency arises. The Trump Administration and its Republican allies in Congress want to give insurance companies the power to deny coverage based on the flimsiest excuse, and this rule does just that. The public knows better than to fall for this charade.”

Today’s announcement is the fifth act of sabotage the Trump Administration and its GOP allies have undertaken in the past week alone. In the past seven days:

  1. The Trump Administration and twenty GOP attorneys general and governors pushed forward their lawsuit in an attempt to strike down protections for Americans with pre-existing conditions.
  2. Not a single Republican Senator or House Member joined the Democratic resolutions authorizing the legislative chambers’ legal counsel to go to court and defend these protections.
  3. House Republicans went home after doing nothing to lower premiums or protect the 130 million Americans with pre-existing conditions.
  4. New Jersey became the 25th state to see its projected premiums rise due to GOP actions. In fact, new data shows Americans will spend $3,000 more per year for marketplace coverage this year.
  5. Now, short term “junk plans could be back on the market.

Read more about this Summer of Sabotage here, and read about all the ways the Trump Administration has sabotaged health care over the past 18 months here.

ABOUT SHORT TERM JUNK PLANS:

  • 335 of 340 health groups, 98 percent of those that submitted comments to HHS, criticized the proposed rule.
  • Short-term junk plans can exclude coverage for pre-existing conditions, affecting 130 million Americans and one in four children.
  • Short-term junk plans can refuse to cover essential health benefits, including maternity care, prescription drugs, mental health care, and preventive care.
  • Short-term junk plans can impose annual and lifetime limits.
  • Short-term junk plans can leave members facing “major, unpredictable financial risk,” with out-of-pocket maximums as high as $20,000 for just three months of coverage.
  • Short-term junk plans can retroactively cancel coverage after patients file claims.

For more information on short term junk plans, view our fact sheet.

###

The People Who Know Health Care the Best Say Short-Term Plans Are the Worst

Yesterday marked the deadline for comments to be submitted on the Trump Administration’s proposed short-term scam insurance. A wide variety of health care experts – including doctors, insurance exchange operators, insurance companies, analysts, and more than 100 patient groups – continue to make clear their strong opposition to the Administration’s proposal. Here’s what they had to say:

American Medical Association: Proposed Rule “Would Result In Substandard, Inadequate Health Insurance Coverage.” “We believe the proposed rule, however, would culminate in plans being offered that fall far short of maintaining crucial state and federal patient protections, disrupt and destabilize the individual health insurance markets, and result in substandard, inadequate health insurance coverage.” [Forbes, 4/22/18]

American Cancer Society Cancer Action Network, American Heart Association, American Liver Foundation, American Lung Association, Arthritis Foundation, Autism Speaks, Chron’s & Colitis Foundation, Cystic Fibrosis Foundation, Epilepsy Foundation, Family Voices, Hemophilia Federation of America, Leukemia & Lymphoma Society, Lutheran Services in America, March of Dimes, Mended Little Hearts, NAMI, National Health Council, National Multiple Sclerosis Society, National Organization for Rare Disorders, National Patient Advocacy Foundation, National Psoriasis Foundation: “Given The History Of Discrimination And Inadequate Coverage Within Short-term Limited-duration Plans, We Are Deeply Concerned That The Proposed Rule Could Seriously Undermine The Key Principles Of Access, Adequacy, And Affordability That Are The Underpinnings Of Current Law – And Put Those We Represent At Enormous Risk.” “Given the history of discrimination and inadequate coverage within short-term limited-duration plans, we are deeply concerned that the proposed rule could seriously undermine the key principles of access, adequacy, and affordability that are the underpinnings of current law – and put those we represent at enormous risk. We urge the Departments to withdraw the proposed rule until the needs of our populations are met and instead, to focus on stabilizing the individual insurance markets and lowering premiums for QHPs.” [ACS-CAN, 4/23]

American Academy Of Family Physicians: “Short-Term, Limited-Duration Plans Will Not Provide Meaningful Insurance Coverage.” “The AAFP strongly opposes the proposed rule since it allows plans to sell low-value insurance policies that could subject patients to catastrophic medical bills and medical bankruptcy. We oppose efforts to exempt short-term, limited-duration plans from consumer protections such as covering preexisting conditions or essential health benefits (EHBs). Furthermore, we oppose allowing any plans to establish caps on annual benefits since limiting benefits can expose patients to extraordinarily high out-of-pocket costs… The AAFP has significant concerns with these proposals since short-term, limited-duration plans will not provide meaningful insurance coverage. While these plans could increase the availability and affordability of services, we do not think doing so should come at the expense of meaningful insurance coverage.” [AFP, 4/18]

America’s Health Insurance Plans: “Not A Replacement For Comprehensive Coverage.” “‘We are concerned that this proposed rule will lead to more people being uninsured and under-insured, and to higher costs in the long run,’ AHIP chief executive Matt Eyles said. ‘Short-term plans can provide an important temporary bridge for Americans who are transitioning between plans. But they are not a replacement for comprehensive coverage.’” [Forbes, 4/23]

Alliance Of Community Health Plans: “The Proposed Rule Will Undermine Consumer Protections.” “The proposed rule will undermine consumer protections because short-term, limited duration plans do not require coverage of essential health benefits or coverage of pre-existing conditions. There is a substantial risk that consumers will not understand the coverage limitations that accompany short term plans. Contracts for medical coverage can be quite complex, and consumers may assume that essential health benefits are covered by short-term, limited duration plans, but for a shorter period of time. This could lead to consumers purchasing health insurance that is inadequate for their medical needs, potentially resulting in personal bankruptcy and an increase in uncompensated care for hospitals and other facilities. There is evidence of this connection between coverage and personal financial status: A Consumer Reports study found that increased health care coverage over the past several years was associated with a reduction by half in the number of personal bankruptcy filings. With the increased use of short-term, limited duration plans, we anticipate a troubling reversal of this trend.” [ACHP, 4/19/18]

American Cancer Society-Cancer Action Network: “We Believe That The Proposed Rule Should Be Withdrawn.” “We are very concerned about policies that would expand access to STLD policies because these products are exempt from important consumer protections, such as prohibitions on lifetime and annual dollar limits, limits on the use of pre-existing condition exclusions, and the prohibition on medical underwriting. These protections are key to ensuring that individuals with cancer (including those in active treatment and survivors) have access to quality health care needed to treat their disease. Without these protections, individuals could find themselves enrolled in policies that fail to provide coverage of medically necessary services. We believe this proposed rule should be withdrawn unless the needs of the patient community have been met.” [ACS CAN, 4/20/18]

American Hospital Association And Federation Of American Hosptials: “Concerned That The Result Will Be Increased Uncompensated Care.” “The American Hospital Association and the Federation of American Hospitals said the proposed rule, if finalized, would drain hospitals’ resources. The federation, which represents investor-owned hospitals, said its members ‘are concerned that the result will be increased uncompensated care, particularly for patients who need uncovered services or treatment for preexisting conditions.’” [Modern Health Care, 4/23]

Association for Community Affiliated Plans: Rule WIll Harm Consumers And Health Care Providers. “The Association for Community Affiliated Plans, a group representing safety-net plans that cover Medicaid, Medicare special-needs and marketplace members, warned that finalizing the rule as proposed would harm consumers and healthcare providers. The group warned that sellers of short-term plans have been known to rescind coverage as soon as an individual becomes ill and files a substantial claim. The space has been riddled with patient lawsuits over unpaid medical bills. ACAP pointed to the recent 42-state investigation into the business and marketing practices of Tokio Marine’s HCC Life subsidiary, a short-term medical insurer. Earlier this month, HCC Life reached a settlement to pay a fine of $5 million. The insurer is also prohibited from selling short-term plans for at least five years. ACAP also warned that skimpy short-term plan benefits would lead to increased uncompensated care.” [Modern Health Care, 4/23]

Heather Korbulic, Silver State Health Insurance Exchange Director: “Deeply Concerned” About Proposed Rule. “The head of Nevada’s health insurance exchange is ‘deeply concerned’ about a proposed federal rule change that would extend the length of short-term health plans, saying in a Friday letter to the Centers for Medicare and Medicaid Services that the policy will likely result in higher premiums for people who purchase insurance on the exchange… Korbulic is just one of many in the health-care field nationwide who has expressed concern that approving the federal rule will siphon off the healthiest individuals from the individual market, leaving behind a sicker, more expensive population. In the letter to CMS, Korbulic wrote that individuals with pre-existing conditions or who anticipate needing medical care will likely remain on the exchange where they can purchase plans with comprehensive health benefits but will likely face premium increases.” [Nevada Independent, 4/23]

American Heart Advocacy: Patients “Will Suffer If This Rule Becomes Law.” “Today is the deadline to tell HHS not to extend short-term health plans. The outcome is clear — Patients living with CVD, stroke survivors and others with pre-existing conditions will suffer if this rule becomes law.” [American Heart Advocacy, 4/23/18]

Matt Slonaker, Utah Health Policy Project Executive Director: Short-Term Plans Designed To Weaken ACA. “Matt Slonaker is the executive director of the Utah Health Policy Project. He said the new plans are a way to weaken the health law. ‘Unfortunately what is happening here is the short-term insurance idea is being used as a guise to erode some of the protections of the Affordable Care Act,’ Slonaker said.” [KUER, 4/23]

Tanji Northrup, Assistant Commissioner of the Utah Insurance Department: Short-Term Plans Could Increase Premiums By Double-Digits. “Tanji Northrup is the Assistant Commissioner of the Utah Insurance Department. She says these new plans will pull people out of ACA plans and make them more expensive. ‘There will definitely be increases because of pulling those healthy people out of the traditional market,’ Northrup said… Northrup says if these short-term plans go through, Affordable Care Act rates could increase by double-digits. She says no insurers in Utah have contacted her department yet to develop these new plans.” [KUER, 4/23]

Mario Molina, Former CEO of Molina Healthcare: Hopefully You Already Have Kids Because Maternity Care Won’t Be Covered. “Hopefully, you had kids already, because under the short-term health plan expansion encouraged by an executive order signed last year, covered maternity care vanishes in 100% of plans analyzed by [the Kaiser Family Foundation]” [Mario Molina, 4/23/18]

Blue Cross Blue Shield Association: Significant Concerns. “[BCBS] has significant concerns that allowing consumers to stay on these plans for a full year ‘would cause rates to increase for those who need or want comprehensive health insurance coverage.'” [Washington Post, 4/24/18]

Larry Levitt, Kaiser Family Foundation Senior Vice President: “These Short-Term Policy Brochures Read Like An Obstacle Course Of Exclusions.” [Washington Post, 4/23/18]

Kaiser Family Foundation: Analysis: Most Short-Term Health Plans Don’t Cover Drug Treatment or Prescription Drugs, and None Cover Maternity Care. “A new Kaiser Family Foundation analysis of short-term, limited duration health plans for sale through two major national online brokers finds big gaps in the benefits they offer. Through an executive order and proposed new regulations, the Trump Administration is seeking to encourage broader use of short-term, limited duration health plans as a cheaper alternative to individual market plans that comply with the Affordable Care Act’s requirements. Repeal of the individual mandate penalty – which currently applies to people buying short-term plans – is also expected to boost enrollment starting next year. The analysis examines 24 distinct short-term insurance products currently marketed in 45 states and the District of Columbia through eHealth or Agile Health Insurance. It finds: 43 percent do not cover mental health services; 62 percent do not cover substance abuse treatment; 71 percent do not cover outpatient prescription drugs; and none of the plans cover maternity care.” [Kaiser Family Foundation, 4/23]

Washington Post: Trump Proposal Could Mean Healthy People Save On Insurance While Others Get Priced Out. “The Trump administration’s proposal to build up short-term health insurance plans as a ‘lifeline’ for people who can’t afford Affordable Care Act coverage could split the insurance market in two, siphoning young, healthy people into cheaper, more minimal plans — while those who remain in ACA plans face premiums that spiral upward even faster… The effects of that policy change, combined with zeroing out the individual mandate’s financial penalty in 2019 will be harmful to the most vulnerable patients, according to more than 100 patient groups and many health policy wonks.” [Washington Post, 4/23]

Las Vegas Sun: Health Experts Concerned About Risks Of Limited-duration Health Plans. “People would be able to stay on a type of sub-par temporary health plan longer under a proposed Trump administration rule, sparking a concern that the plans won’t give consumers sufficient coverage. The proposal would lift the cap on short-term limited duration plans from six months to just under a year to give more options to consumers who cannot afford the rising cost of health care, according to the Department of Health and Human Services and other agencies involved. The plans can be much cheaper, but do not carry Obamacare-required benefits such as coverage for preexisting conditions.” [Las Vegas Sun, 4/23]

The Hill: Insurer Group Issues Warning On Trump Administration’s Short-Term Health Plan Proposal. “The nation’s largest trade group for health insurance companies is sounding the alarm on a proposal from the Trump administration that would expand the sale of plans that cover fewer services.  America’s Health Insurance Plans (AHIP) says the proposal could lead to more people being uninsured or underinsured and result in higher health-care costs in the long run.” [The Hill, 4/23]

Forbes: Health Insurers: Trump’s Short-Term Plans Will Trigger Loss Of Coverage. “The Trump administration’s proposed cheaper short-term plans may not provide adequate coverage and would trigger an increase in the number of uninsured and under-insured Americans, say health insurers that would be expected to sell such coverage. Through their lobby, America’s Health Insurance Plans, companies Monday were the latest to weigh in on the Trump administration’s proposed rule on short-term plans… Health insurance companies Monday morning issued their critique of the Trump administration’s proposal, joining a parade of doctor groups concerned about any effort to reduce coverage or pare benefits.” [Forbes, 4/23]

Healthcare Dive: Payer Trade Groups Slam Short-term Health Plan Proposal. “The Alliance of Community Health Plans (ACHP) and America’s Health Insurance Plans (AHIP) both slammed CMS’ proposal to expand short-term, limited duration (STLD) insurance plans, saying the proposed rule would undermine key consumer protections, lead to higher premiums in the individual market and jeopardize market stability.  The proposed rule, pushed by the Trump administration as a way to increase access to cheaper plan alternatives and sidestep the Affordable Care Act, would allow consumers to purchase plans for up to 12 months that do not adhere to federal rules for individual health insurance. STLD plans can charge those with pre-existing conditions more and may not cover ACA essential health benefits such as prescription drug coverage. The insurance lobbies argued that other policy mechanisms would be more effective at improving the individual health insurance market.” [Healthcare Div, 4/23]

Washington Times: Insurers’ Lobby Asks Trump To Curtail Short-term Insurance Plan. “Health insurers’ main lobbying group urged the Trump administration Monday to curtail its push to let Americans get around Obamacare by purchasing cheap ‘short-term’ plans for a full year, saying consumers will be left with skimpy coverage. Matt Eyles, the incoming president and CEO of America’s Health Insurance Plans, also said the plan — if it proceeds — should not be enacted until 2020, so insurers have time to plan for a reconfigured marketplace.” [Washington Times, 4/23]

Washington Examiner: Trump-Backed Short-Term Health Plans Have Big Gaps In Benefits, Analysis Finds. “Short-term health insurance plans that the Trump administration wants to expand don’t offer the same benefits of Obamacare plans, a new analysis found. A study from the health research firm Kaiser Family Foundation looked at how short-term plans cover the same benefits as Obamacare. The healthcare law requires plans sold on Obamacare’s insurance exchanges to cover 10 essential health benefits that include mental health services, prescription drug coverage, and maternity care. The Trump administration is seeking to expand the duration of the short-term plans from 90 days to nearly 12 months. These plans are cheaper than Obamacare plans because in part they do not have to cover as many benefits.” [Washington Examiner, 4/23]

Forbes: Doctors Attack Trump’s Short-Term Health Plans Ahead Of Comment Deadline. “An effort by the Trump administration to introduce cheaper short-term health insurance plans is under attack by physician groups who see the plans eliminating benefits and putting patient health at risk. The American Academy of Family Physicians and other doctor groups have unleashed detailed critiques of Trump’s effort to introduce cheaper health insurance with skimpier benefits ahead of a Monday deadline at 5 pm to provide public comments to the administration.” [Forbes, 4/22]

Vox: If You Need Prescriptions Or Maternity Care, You Won’t Like Trump’s Short-term Insurance Plans. “Short-term plans are much less likely to cover mental health and substance abuse treatment or prescription drugs — all of which must be covered by ACA plans. What is insurance, you might ask, if it doesn’t cover medications? This is also a setback for the ongoing effort to have mental health and substance abuse treated as equal to other physical health needs.” [Vox, 4/23/18]

Healthcare Dive: Report Finds Most Short-term Plans Don’t Cover Maternity, Substance Misuse Care. “A Kaiser Family Foundation report argues that recent efforts to promote short-term plans could have an adverse effect on the Affordable Care Act-compliant individual market, creating higher premiums for compliant plans and potentially leaving a greater number of people uninsured.  The expansion of short-term plans, along with the elimination of the individual mandate penalty, could also make it difficult for people who need behavioral health services and substance misuse treatment, which aren’t typically covered benefits under those plans. The Trump administration’s plans for short-term expansion would primarily impact the middle class, as lower-income people are protected from premium increases through the use of federal subsidies, KFF said.” [Healthcare Dive, 4/24]

Insurance News Net: Trump Administration Implored To Curtail Short-Term Plan. “Health insurers, patient groups and Senate Democrats implored the Trump administration Monday to curb or cancel its push to let Americans get around Obamacare by using cheaper, short-term health plans for a full year, saying the plan would destabilize the insurance markets and increase the number of uninsured… More than 100 patient-advocacy groups protested the proposal Monday, the final day to submit comments to HHS, noting the full-year plans could duck Obamacare rules requiring robust coverage or preventing insurers from denying sicker patients or charging them more than healthy ones.” [Insurance News Net, 4/24]

Modern Health Care: Insurers, Hospitals Warn Short-term Plans Aren’t The Answer. “Several health insurance and hospital associations urged HHS to spike the proposed rule to expand access to short-term, limited-duration health insurance, warning it would lead to higher premiums for Affordable Care Act-compliant plans and more uncompensated care delivered at hospitals. Meanwhile, stakeholders in the short-term insurance market encouraged HHS to finalize the proposed rule allowing the sale of short-term plans with durations of up to 12 months, saying the extension would lead to lower premiums and more options for consumers. It is clear those stakeholders would see more customers and higher revenue if the proposed rule is finalized.” [Modern Health Care, 4/23]

Washington Examiner: Healthcare Groups Plea With Trump Administration To Nix Short-Term Insurance Plan Rule.  “A wide array of doctor, insurer, and other major healthcare groups pleaded with the Trump administration to nix plans to expand short-term insurance plans… Healthcare groups say in comments to the proposed regulation, which were due Monday, the plans are no better than “junk insurance” that erode patient protections. The regulation would expand the duration of the short-term plans from 90 days to nearly 12 months.” [Washington Examiner, 4/23]

47 Senators: The Proposed Rule Will “Increase Costs And Reduce Access To Quality Coverage For Millions Of Americans, Harm People With Pre-Existing Conditions, And Force Premium Increases On Older Americans.” “If finalized, the rule could increase costs and reduce access to quality coverage for millions of Americans, harm people with pre-existing conditions, and force premium increases on older Americans. This rule expands the sale and marketing of “junk plans” that exclude basic benefits including hospitalization, prescription drugs, mental health services, substance abuse treatment, and maternity care. We urge you not to finalize the proposed rule and instead work with us to ensure that all American families have choices of affordable, meaningful health care coverage.” [State of Reform, 4/23]

AARP Study: Trump’s Junk Plan Rule Punishes Older Americans

60-year-olds set to pay $2000 more in premiums next year after latest Trump sabotage

According to a new study by the AARP, the Trump Administration’s plot to let insurance companies sell junk plans would cause premiums for older Americans to jump by double digits next year, with the average 60-year-old paying an average of 16.6% more for individual-market coverage. In response, Protect Our Care Campaign Director Brad Woodhouse released the following statement:

“Too many older Americans are already getting squeezed, and now a new AARP study proves that Trump’s new junk health insurance proposal would not only hurt those stuck with junk coverage, but would also drive up costs for people over age 50 who buy real insurance. If the Trump Administration’s junk plan proposal moves forward, older Americans will face an eye-popping average increase of over $2000 in annual premiums next year. This latest attack in the Trump Administration’s health care sabotage campaign must be stopped before it drives rates even higher, leaving older Americans struggling to pay the price.”

STATE-BY-STATE AARP ESTIMATES