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Two Fronts of a Continuing Assault: The GOP Finalizes Junk Insurance Plans and Announces Another Repeal Bill

By June 19, 2018No Comments

This afternoon, conservative groups announced their latest plan to repeal the Affordable Care Act. Across town the Trump Administration announced a finalized rule on association health plans. In other words, it was just another day in the GOP’s war on Americans’ health care.

NO RAVES FOR REPEAL RETREAD

Wall Street Journal: “The Latest Plan Is One Front Of A Continuing Assault On The ACA By Republicans.” “The latest plan is one front of a continuing assault on the ACA by Republicans and conservatives in the aftermath of the failed previous effort to repeal it. While the Justice Department has asked a court to toss out key provisions of the health law, the 20 GOP state attorneys general in the lawsuit want the court to end the law altogether.” [WSJ, 6/19]

The Hill: “The Plan Eliminates Obamacare’s Essential Health Benefits.” “Experts note that block grants, though, could lead to cuts in health services if they do not grow over time in the way that the current open-ended system does. The plan also eliminates ObamaCare’s essential health benefits, which require plans to cover a range of services like mental health and prescription drugs. Backers argue this would lead to cheaper plans being available.” [The Hill, 6/19]

Los Angeles Times: “The New Approach Would Scrap Many Of The Current Law’s Insurance Protections.” “The new approach would scrap many of the current law’s insurance protections, including its system of guaranteeing coverage to low-income Americans through either Medicaid or subsidized commercial insurance. ‘The proposal would repeal the individual entitlement to premium and cost-sharing reduction subsidies and Medicaid expansion,’ note the authors… Many of the repeal proposals envisioned not only rolling back the current law but restricting federal funding for the entire Medicaid program, which covers more than 70 million low-income Americans.” [Los Angeles Times, 6/19]

Insurance News Net: Plan “Would Eliminate The ACA’s Medicaid Expansion As Well As The Subsidies That Help People Buy Coverage.” “Groups led by the Heritage Foundation, the Galen Institute and former Sen. Rick Santorum, R-Pa., drafted the plan, which will be formally announced Wednesday. It would eliminate the ACA’s Medicaid expansion as well as the subsidies that help people buy coverage. Instead, it would convert that money into block grants for the states… In addition, the plan would eliminate the essential health benefits that plans are required to cover under the ACA.” [Insurance News Net, 6/19]

National Review: “Broadly Speaking, This Is Similar To The Graham-Cassidy Bill.” [National Review, 6/19]

Center On Budget And Policy Priorities: New Proposal “Would Have The Same Severe Effects On Health Insurance Coverage, Access To Care, And Many Americans’ Health And Financial Security As Last Year’s Repeal Bills.”  “The new plan to repeal the Affordable Care Act (ACA) would have the same severe effects on health insurance coverage, access to care, and many Americans’ health and financial security as last year’s repeal bills.  Like them, it would eliminate the ACA’s Medicaid expansion for low-income adults, lead to sharply increased health care costs for millions of moderate-income individual-market consumers — especially older people — eliminate consumer protections that are especially crucial for people with pre-existing health conditions, and cause millions to lose coverage.” [CBPP, 6/19]

Center For American Progress: “Graham-Cassidy 2.0 Could Cut ACA Funding For Coverage By 31 Percent By 2028.” “Although this is a new plan, it merely recycles some of the worst elements of the failed Graham-Cassidy repeal bill—which experts consider the “the most harmful” repeal bill.5 Graham-Cassidy 2.0 would lead to the same disastrous results: Millions of Americans would lose health care coverage; Protections for pre-existing conditions would be decimated; Costs would increase for lower-income, older, and sick Americans; Massive disruption would occur, causing insurers to drop out of marketplaces… Based on the plan’s specifications and the Congressional Budget Office’s (CBO) updated baseline of ACA funding under current law, the Center for American Progress estimates that Graham-Cassidy 2.0 could cut ACA funding for health coverage by 31 percent by 2028 and by 26 percent  from 2022 to 2028.” [CAP, 6/19]

ASSOCIATION HEALTH PLANS PANNED

CNN: “The Move Could Weaken” Consumer Protections “And Make Coverage More Expensive.” “The Trump administration is taking the final step Tuesday in its plan aimed at making health insurance policies cheaper for some small businesses. But the move could weaken some of the Affordable Care Act’s consumer protections for those buying these plans and make coverage more expensive for those who remain on the Obamacare exchanges.” [CNN, 6/19]

Associated Press: “State Regulators Are Concerned About Association Health Plans Because Similar Plans In The Past Had Problems With Financial Solvency And Even Fraud.” “State insurance regulators are concerned about association health plans because similar plans in the past had problems with financial solvency and even fraud. A big concern about Tuesday’s announcement is to what degree state regulators will retain oversight over the Trump administration’s new plans.” [USA Today, 6/19]

New York Times: Plans “Could Drive Up Premiums, Which Have Increased As Mr. Trump And Republicans In Congress Have Undercut Many Elements Of The [ACA].” “But consumer groups, state officials and Blue Cross Blue Shield plans have long opposed such ideas. They say association health plans will tend to attract employers with younger, healthier workers, leaving behind sicker people in more comprehensive, more expensive plans that fully comply with the Affordable Care Act. That could drive up premiums, which have increased as Mr. Trump and Republicans in Congress have undercut many elements of the law, President Barack Obama’s signature domestic achievement.” [NYT, 6/19]

Washington Post: “The Move Could Be Characterized As Sort Of An ‘Obamacare Repeal Plan B.’” “Association plans have been around for years, but the Trump administration is expanding eligibility as a way to provide cheaper options for people to afford health insurance. The move could be characterized as sort of an ‘Obamacare Repeal Plan B’ made up of efforts by Trump appointees to pull back on the law administratively now that Congress has failed to eliminate the ACA.” [Washington Post, 6/19]

Chris Hansen, American Cancer Society: People With Serious Illnesses Like Cancer Could Face ‘Ever-Increasing Premiums For Comprehensive Coverage.” [NYT, 6/19]

Avalere: Rule Will “Increase Premiums As Much As 4 Percent.” “Avalere Health, a Washington D.C.-based consulting firm, predicted 4.3 million people would leave the individual and small-group markets, which would increase premiums as much as 4 percent by 2022. Avalere performed the analysis for America’s Health Insurance Plans, the lobbying group for the health insurance industry.” [USA Today, 6/19]

Wall Street Journal: Due To Plan, “Costs For Consumers Who Buy Their Own Coverage On The Individual Market Are Likely To Rise.” “While premiums for association plans will probably be significantly cheaper, costs for consumers who buy their own coverage on the individual market are likely to rise, analysts say. Those higher premiums are expected to increase the number of Americans without coverage.” [WSJ, 6/19]

Wall Street Journal: “Associations With A Preponderance Of Female Employees Could Be Charged More.” “Women couldn’t be charged more within individual plans, but associations with a preponderance of female employees could be charged more overall, according to the senior Labor Department official. Some critics have said women and older people will pay more, and they’ve said the plans will essentially be able to discriminate against consumers by offering some benefits and omitting others, such as cancer treatments or certain prescriptions.” [WSJ, 6/19]

CNBC: “Health Providers, Insurers And Medical Groups Have Warned That The Plans Could Drive Up Premiums And Make Insurance Unaffordable.” “These insurance plans would not be subject to requirements under the Affordable Care Act, which included mandatory coverage for 10 essential health benefits, such as maternity and newborn care, prescription drug costs and mental health treatment… Health providers, insurers and medical groups have warned that the plans could drive up premiums and make insurance unaffordable for some people by siphoning healthy consumers who want cheaper coverage, leaving behind a pool of sicker patients with higher medical costs in ACA plans.” [CNBC, 6/19]

Vox: AHPs “Are Not Required To Cover All Of The Essential Health Benefits Mandated By The Affordable Care Act.” “Association health plans, the subject of the new rules, do not have to follow the same rules as individual policies sold under Obamacare, meaning they are not required to cover all of the essential health benefits mandated by the Affordable Care Act, like maternity care, an important piece of the law’s protections for people with preexisting conditions.” [Vox, 6/19]

Larry Levitt, Kaiser Family Foundation: “The Clear Intent Of The Executive Order Is To Create A Parallel Insurance Market Exempt From Many Of The Consumer Protections In The Affordable Care Act.” “‘The clear intent of the executive order is to create a parallel insurance market exempt from many of the consumer protections in the Affordable Care Act,’ Larry Levitt at the Kaiser Family Foundation told me last year. ‘This has the potential to siphon off healthy people with skinnier benefits and cheaper premiums, leaving behind a sicker pool of people under ACA plans.’” [Vox, 6/19]

Karen Pollitz, Kaiser Family Foundation: “They Could Have A Destabilizing Effect.” “‘To the extent that these plans develop and serve as a parallel market, that could have a destabilizing effect,’ said Karen Pollitz of the nonpartisan Kaiser Family Foundation, an expert on individual health insurance. Pollitz also served as a consumer protection regulator in the Obama administration. ‘People who think they can get by without those (comprehensive) benefits will look for cheaper premiums,’ she added.” [USA Today, 6/19]

Politico: “Critics Warn The Steps Will Further Destabilize” Insurance Markets. “Critics warn the steps will further destabilize wobbly Obamacare markets by siphoning off younger and healthier customers, who are more likely to favor cheaper plans that cover less. The law’s insurance markets have already been beset by skyrocketing premiums and diminishing competition, problems that are likely to grow worse if the customer base becomes even smaller and sicker.” [Politico, 6/19]

Highmark CEO David Holmberg: Rule Change “Creates A New Set Of Uncertainties.” “Highmark CEO David Holmberg said the health insurer, which is finally making money on Obamacare customers after years of losses, is committed to remaining in the law’s markets in Delaware, Pennsylvania and West Virginia. However, he said the changes coming out of Washington are adding new challenges. ‘We can see a path where we could stabilize this, but we continue to see rule changes,’ Holmberg told POLITICO. ‘That creates a new set of uncertainties.’” [Politico, 6/19]

Families USA: “With Surgical Precision, The Proposed Rule Repeals The Most Important Limitations On AHP Sales.” “With surgical precision, the proposed rule repeals the most important current limitations on AHP sales: Under federal law, AHPs are supposed to be business associations offering insurance plans to their business members… Currently, when small businesses buy plans through an association like the chamber of commerce, those plans still must include the protections that apply to other small groups, and the plans are subject to state and federal oversight. This would all change under the proposed rule. An AHP could be offered by a supposed ‘association’ that does nothing but provide health insurance. That ‘association’s’ membership could be united by just residence in a common geographic area or work in the same trade or industry. While an AHP cannot explicitly exclude people or companies based on health status, health costs, or health conditions, an AHP can use ‘redlining’ to avoid high-cost members, excluding particular geographic areas or lines of work that tend to be associated with high health care expenses.” [Families USA, 6/19]