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cover of episode Short‐​Term Plans: The Battle for Health Insurance Choice

Short‐​Term Plans: The Battle for Health Insurance Choice

2023/9/11
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Cato Event Podcast

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Brian Blase
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Michael Cannon
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Michael Cannon: 拜登政府提议修改短期有限持续期保险的定义,这将对个人产生负面影响,因为它消除了消费者保护,导致病人失去保险面临巨额医疗账单。短期保险市场为低收入人群提供了负担得起的医疗保险选择,而拜登政府的提案将使这些人面临长达12个月的无保险状态。2018年的规定允许短期保险计划提供续保保证,这使得即使生病也能继续获得保险,并能更好地解决既有疾病问题。拜登政府的提案如此危险,以至于需要警告标签,这表明该提案不应被提出。《平价医疗法案》市场存在问题,例如保费上涨、选择减少、网络缩小以及对既有疾病患者的保障不足,导致人们转向短期保险市场。拜登政府试图通过限制短期保险来鼓励人们加入《平价医疗法案》计划,其理由是区分ACA计划和短期计划、降低ACA保费和减少补贴支出,但实际上是将负担转移给了健康人群。建议拜登政府撤回该提案,维持现行规则,允许短期保险计划持续12个月,最多续保36个月,并允许发行人向投保人出售单独的续保保证。 Brian Blase: 拜登政府的提案是错误的,将会减少消费者的选择,大多数评论反对该提案。2018年特朗普政府的规则恢复了短期保险计划的期限,并允许续保,这有益于消费者。短期保险计划是全面的产品,提供广泛的服务和医院网络,并且全年皆可购买。各州对短期保险计划的监管存在差异,一些州完全遵守2018年的规则,而另一些州则对其进行了限制或禁止。拜登政府的提案将短期保险计划期限缩短至4个月,并禁止续保,这比奥巴马政府的规定更为严格。2018年特朗普政府的规则预计将减少180万无保险人数,而拜登政府的提案将增加无保险人数。美国人有权选择最适合自己的医疗保健方式,限制短期保险计划违反了这一原则。拜登政府的提案将剥夺病人的医疗保障,使他们面临无保险和无法支付医疗费用的风险,尤其是在失业期间。拜登政府的提案不符合良好的监管审查标准,并且没有证据表明短期保险计划比《平价医疗法案》计划更令人沮丧。缩短短期保险计划期限会降低医疗损失比率,这与拜登政府的论点相矛盾。数据表明,允许短期保险计划的州的《平价医疗法案》市场表现更好,这与拜登政府的论点相矛盾。建议只在开放注册期间适用这些不合理的规定,其余时间允许短期保险计划根据现有规定运作,以最大限度地保护消费者。

Deep Dive

Key Insights

Why did the Biden administration propose changes to short-term health insurance plans?

The Biden administration proposed changes to short-term health insurance plans to encourage people to enroll in ACA plans, reduce spending on Obamacare subsidies by $120 million per year, and bring down ACA premiums by 0.5% by forcing healthy people to leave the short-term market.

What are the current rules for short-term health insurance plans?

Under current rules, consumers can purchase short-term health insurance plans with an initial contract period of up to 12 months and renew them for up to 36 months. Insurers can also offer renewal guarantees that allow enrollees to re-enroll without medical underwriting.

How do short-term health insurance plans compare to ACA plans in terms of cost and coverage?

Short-term health insurance plans often have lower premiums (up to 60% lower than the lowest-cost ACA plans) and lower deductibles. They may exclude some ACA-mandated benefits like maternity care but offer broader provider networks and more comprehensive coverage for high-cost medical events.

What risks do the proposed Biden administration rules pose to short-term health insurance enrollees?

The proposed rules would cancel short-term plans after just four months, leaving enrollees without coverage for up to 12 months if they develop expensive illnesses. This could result in uninsured periods and substantial medical bills for those affected.

What is the impact of the Biden administration's proposed rule on the ACA market?

The proposed rule aims to reduce ACA premiums by 0.5% by shifting healthier individuals from short-term plans to ACA plans, but it does not address the underlying issues in the ACA market, such as high premiums and declining insurer participation.

How do renewal guarantees in short-term plans benefit consumers?

Renewal guarantees allow consumers to re-enroll in short-term plans without medical underwriting, ensuring that they can maintain coverage even if they develop a costly illness. This reduces the risk of being uninsured and facing high medical bills.

What was the outcome of the Trump administration's 2018 rule on short-term health insurance plans?

The 2018 rule restored short-term plans to a 364-day contract period and allowed renewals for up to three years. It reduced the uninsured rate by an estimated 1.8 million people and provided a viable alternative to ACA plans.

How does the Biden administration's proposed rule affect unemployed individuals?

The proposed rule restricts short-term plans to four months, which is often shorter than the average unemployment duration. This leaves unemployed individuals without coverage for extended periods, increasing their financial and health risks.

What evidence suggests that short-term plans benefit the ACA market?

States that allow short-term plans have seen better trends in ACA markets, including higher exchange enrollment (63% increase), more insurers (105% increase), and lower premiums compared to states that restrict short-term plans.

What are the potential legal challenges to the Biden administration's proposed rule?

Legal challenges could argue that the rule is arbitrary, capricious, and contrary to law, as it cancels health insurance for sick individuals and creates gaps in coverage, which contradicts congressional intent to reduce uninsurance and protect those with pre-existing conditions.

Shownotes Transcript

On July 7, 2023, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury released a notice of proposed rulemaking to modify the definition of short‐​term, limited‐​duration insurance. During this policy forum, Michael F. Cannon and Brian Blase will discuss why the proposed rule would adversely impact individuals by eliminating consumer protections, which would throw sick patients out of their health insurance and leave them to face sky‐​high medical bills without insurance for up to a year. Hosted on Acast. See acast.com/privacy) for more information.