Daily Record, The
(Wooster, OH) August 7, 2018
During his presidential campaign,
then-candidate Donald Trump promised to replace Obamacare with
“something terrific.”
For a long time, that “something terrific” was left
unspecified. Now, more than a year and a half into Trump’s presidency, we have
finally learned his grand plan for reducing Americans’ health-care costs.
It is: Don’t get sick. Ever.
That, at least, was the message of the administration’s
new rule expanding the availability of junk insurance plans, finalized
Wednesday.
The rule deals with “short-term” health plans. Short-term
plans were initially designed to do exactly what they sound like: provide
stopgap coverage to tide consumers over until, say, school starts in the fall
or that new job begins.
Under the Trump administration’s new regulation, however,
these plans will soon be allowed to last up to 364 days and to be renewed for
up to 36 months. So, not so short after all.
There’s a reason Trump wants short-term plans to last such
a long time. That way, they’ll look like an attractive alternative to insurance
for sale on the Obamacare exchanges, with one key difference: Unlike Obamacare
plans, short-term insurance doesn’t actually have to insure anything.
Seriously. Unless states step in, these not-so-short-term
“short-term” plans are not subject to any of the protections required by
the Affordable Care Act.
Short-term plans can turn away people with pre-existing
conditions, including asthma and acne. They can charge older or sicker people
prohibitively expensive premiums.
Or they can enroll such people at what looks like a
bargain-basement price and then refuse to pay for any care related to
pre-existing illnesses -- including illnesses that enrollees didn’t even know
they had when they enrolled, such as cancer or heart disease. Some plans have
dropped consumers as soon as they got an expensive diagnosis, sticking them
with hundreds of thousands of dollars in unexpected medical bills.
Unlike Obamacare plans, short-term plans also are not
required to cover any particular benefits, even for the relatively healthy.
A Kaiser Family Foundationreview of short-term plans offered around the
country found that most did not cover prescription drugs, and none covered
maternity care. Preventive and mental-health care are also frequently excluded.
Even care listed as “covered” is often subject to
ridiculously low or otherwise absurd payout limits. Think: a policy term maximum
of $3,000. Or no coverage for any hospital stay that begins on a weekend.
The tiny print can be endless. And as former head of
the Centers for Medicare and Medicaid Services Andy Slavitt points
out, consumers will never, ever be as good at reading the fine print as
insurance companies will be at writing it.
Because these plans cover so little, cherry-pick their
enrollees and pay out so infrequently, premiums tend to be dirt-cheap. The
Trump administration estimates that people who purchase short-term plans will
pay about half the average unsubsidized premium on the Obamacare exchanges.
How could the availability of cheaper insurance possibly
be a bad thing, you ask?
A few reasons.
This parallel system of insurance will siphon off
healthier, younger, less expensive people from the exchanges. That will leave
behind a pool of sicker, older, more expensive people, which will drive up
premiums on the exchanges.
The combination of expanding short-term plans and
repealing the individual mandate will increase Obamacare premiums by an average
of 18 percent in the 42 states (and the District) that don’t already prohibit
or limit short-term plans, according to an Urban Institute study.
People with incomes low enough to qualify for Obamacare
subsidies will be at least partly shielded from these premium hikes, of course.
The federal government will instead be on the hook for their higher costs; as a
result, the Trump administration estimates that its new short-term insurance
rule will increase federal spending $28 billion over the next decade.
However, middle-class people who don’t qualify for
Obamacare subsidies -- yet still, you know, need real insurance -- will be
stuck paying the higher rates themselves.
And what about those lucky, healthy people who might
celebrate the greater availability of cheap plans?
They won’t be celebrating if their kid breaks a leg, or
they try to fill a prescription or (heaven forbid) they face a more serious
health scare.
That’s when they’ll discover the insurance that seemed so
cheap is cheap only because it’s worthless -- and that their “catastrophic
coverage” doesn’t even cover catastrophe. If they want to pay their
“catastrophic” medical bills, they’d better luck into a job with decent
insurance. Or join the hundreds of thousands who are begging strangers online
for charity.
Which brings us back to Trump’s real plan for American
consumers: Stay healthy, or drop dead.
Catherine Rampell’s
email address is crampell@washpost.com. Follow her on Twitter,
@crampell.
CREDIT: CATHERINE
RAMPELL
No comments:
Post a Comment