Get your Practice Analysis done free of cost. Please call 888-720-8884

Short-Term Health Plans – New Issue Brief From The Commonwealth Fund

Low-value health payer plans and short-term health plans are just to attract consumers for profits with fewer services being provided shortly. Those individuals who were between jobs or in other situations in which they could not obtain their health payer coverage were attracted by such short term health plans. But at least there is an assurance of some type of health care to be provided to the patients in this plan.

ACA Marketplace Stability and Health Insurance Premiums:

Though promising, these plans do not have to comply with coverage provisions included in the Affordable Care Act (ACA). With pre-existing conditions or coverage of certain preventive care, such plans hardly add any protection for patients still; they come with some minor expenses. This limited coverage leads to the coverage to the limit of 12 months by previous regulations.  Further, more comprehensive healthcare coverage was sought by consumers after this period of 12 months. This enrolment limitation was overturned by the 2018 August rule of Trump administration. Wherein, instead of just 12 months, now patients are allowed to remain enrolled in a short-term plan for up to three years.

The Affordable Care Act (ACA) helped to lower the premiums in the non-group market for the older and sicker consumers in the society but it raised for the youngsters and healthy ones; especially those young men who have higher incomes but are ineligible for premium subsidies. Those consumers whose premiums gradually fell because of the ACA’s rating rules were more likely to get non-group coverage as compared to those ones whose premiums rose. Despite this drastic change, all the consumers including higher-income young men gained coverage because of the combined effects of ACA changes which were found to be a better one to enhance healthcare services.

State Health Policy:

Hawaii, Massachusetts, Minnesota, Vermont, and Utah are the top-ranked states according to the Commonwealth Fund’s 2018 Scorecard on State Health System Performance, which assesses all 50 states and the District of Columbia on more than 40 measures of access to health care, quality of care, efficiency in care delivery, health outcomes, and income-based health care disparities.

The main aim of The Commonwealth Fund is to enhance the performance of the health care system to a higher level which can promote easier and better access with improved quality and much greater efficiency specifically for the most vulnerable section of the society including low-income people, the uninsured, minority Americans, young children, and elderly adults.

The State regulation of coverage options outside of the affordable care act led to the limiting of the risk to the individual market places. Whereas, the alternative coverage arrangements, which do not comply with the affordable care act protection shows lower upfront costs but offer fewer benefits than ACA-compliant insurance.  This observation looks at how states regulate coverage arrangements that do not comply with the ACA’s individual health insurance market reforms.

For the states those do not take steps aiming towards services to protect consumers, premium costs for ACA-compliant coverage are likely to rise and consumers will discover it for too late that their short-term plan does not provide the protection they expected they will receive. Eventually, the increasing number of people will be likely left with denied claims or find themselves uninsured when their coverage is rescinded.

Still, there is short term market feasibility for these regulating efforts; even if the effects of these state actions on the outsourced insurance markets are still unpredictable.

Share this post