Jonathan Keisling June 29, 2018
In February, the Trump Administration released
its proposed rule on short-term limited-duration insurance (STLDI) plans for
health care. The rule would change the legal duration of STLDI plans from three
months to 364 days, allowing them to function like traditional insurance. This
rule, partnered with the individual mandate penalty of $0 beginning in 2019,
will likely produce observable effects for the non-group insurance marketplace.
STLDI plans do not need to comply with the Affordable Care Act’s insurance
market reforms and therefore feature a narrower range of benefits partnered
with premiums that are significantly lower on average.
Multiple scorekeepers have weighed in on what
effects the proposed rule might have.
Each of the analyses in the table above had its
own set of assumptions and objectives. The Congressional Budget Office noted its
results within its most recent baseline update. The Urban Institute and the Commonwealth Fund sought to analyze the
STLDI rule, but they both also included in their analyses the combined effects
of the new individual mandate penalty and the STLDI rule. Meanwhile, the Center for Health and Economy already
included the new mandate penalty in their baseline and only considered the
effects of the STLDI rule.
Correctly predicting the future is hard in
general, and scoring STLDI plans presents its own peculiar challenges. The
scorekeepers point out that this rule will affect every level of the insurance
marketplace. Factors that could change include: insurers’ decisions to offer
qualified health plans, insurers’ rate setting, risk-pool make up, consumer
behavior, and STLDI plan designs themselves. Each score deals with these
uncertainties differently, either by providing a range of outcomes or by
outlining their assumptions.
What can be learned from the analyses? Despite
the differences in the aims of each score and the magnitudes of its
predictions, there seems to be a consensus that, by virtue of their low
premiums, STLDI plans will be attractive to consumers, and thus enrollment will
likely be in the millions. Each scorekeeper concludes that both those currently
insured and the uninsured will purchase STLDI plans, and that premiums will
rise in other non-group plans because some of those currently insured will
shift into STLDI plans. Yet even though premiums for the rest of the non-group
marketplace will rise, each scorekeeper expects non-group enrollment to
increase overall.
Whether or not these outcomes ultimately prove
good for consumers and the market, the administration’s new regulation on STLDI
plans will be consequential.
https://www.americanactionforum.org/weekly-checkup/short-term-insurance-scoring-roundup/#ixzz5K6oB04M2
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