The Trump administration is asking its critics to cool it over their Obamacare rhetoric, saying the new “skimpy” plans the Health Department wants to allow are a way to create more choices, not to undermine the 2010 health-care law.
Those skimpy plans, which the government says will be more affordable but won’t cover as many services, are key to Republicans’ hopes of heading off premium shock for consumers amid Obamacare chaos.
Democratic-led states have balked at the plans, calling them part of an effort to sabotage the health law.
But Health and Human Services Secretary Alex Azar said it’s people left behind by the Affordable Care Act who need the most help, and he urged state leaders to approve expanded “short term” plans.
“This affordable option will only be as available as state legislators and insurance commissioners allow it to be,” he told the American Legislative Exchange Council, a nonprofit for conservative state legislators.
Under the new rules the administration approved at the beginning of the month, short-term plans can last up to a full year — up from the three-month cap President Barack Obama set in 2016. The plans can be renewed for two additional years.
The short-term plans don’t have to cover the full menu of benefits that Obamacare requires, such as mental health or maternity care, and do not have to accept people with pre-existing conditions.
Democrats argue the plans will be more attractive for younger and healthier customers, enticing them out of Obamacare’s regular markets and leaving older, sicker people to pay more because their risk pool has deteriorated.
Maryland and Vermont passed laws that restore the duration of short-term plans to just three months and prohibit renewals, while Hawaii barred insurers from selling the bare-bones plans to anyone eligible for Obamacare’s more-robust, and expensive, coverage.
Mr. Azar said those states are stymying consumers who want the more affordable options.
“We believe sensible state regulation of these plans is important,” he said. “But millions of Americans are in need of affordable insurance options, and states can help build this market outside of Obamacare’s broken regulations.”
Some insurance commissioners have questioned the value of longer short-term plans, saying customers may sign up and then not realize an injury or surprise health condition isn’t covered.
The main insurers’ lobby, America’s Health Insurance Plans, aired similar concerns after President Trump finalized his plan Aug. 1.
“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,” AHIP President and CEO Matt Eyles said.
Yet the Trump administration says consumers are clamoring for more options, citing a 20-percent drop in the number of unsubsidized enrollees in Obamacare from 2016 to 2017.
The push to extend short-term plans followed Mr. Trump’s decision to let small employers within a geographic area or like-minded trades to band together and buy “association health plans” that do not have to cover as many things as Obamacare plans do, so they’re cheaper.
The administration says the ultimate goal is to replace Obamacare with a program that bundles together federal health funding and empowers the states to spend it as they see fit — a block-grant idea that fell short of the needed votes in late 2017, before the GOP turned to tax reform.
“Completely undoing the damage of Obamacare will require Congress to repeal and replace the law itself,” Mr. Azar said. “But until that happens, this administration remains committed to repealing and replacing the ideology that underlies it: undoing the unnecessary restrictions on consumer choice, and replacing them with free-market solutions that really work.”
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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