The proposed rule on short-term plans hinges on the issue of renewability.
The Trump administration's new proposal on short-term health plans may open up more affordable options to consumers and new business opportunities for health plans, but much of the impact depends on making the plans renewable to the enrollee.
Easing the renewability rule is what will make short-term plans significantly more attractive, an analyst says.
The proposed rule would allow consumers to purchase health insurance coverage for a period of up to 12 months, a significant change from the Obama-era rule that limited short-term plans to a maximum of three months. That rule had been in effect only briefly, from April 2017.
The rule proposed last week marks the administrative follow-up on an order issued by President Trump in November 2017. That executive order was widely seen as a positive move by those who need or prefer to purchase short-term insurance rather than a standard plan that is compliant with the Affordable Care Act.
Short-term plans offer lower premiums and deductibles, but they are not required to offer the same essential health benefits as an ACA-compliant plan. They are used by consumers who missed the open enrollment period and those with limited or no options on the healthcare exchanges as well as those in the "Medicaid gap" who make less than 100% of the federal poverty level but live in a state that did not expand Medicaid.
Another blow to Obamacare
Trump's move to make short-term plans more available to consumers was welcomed by some health plans that saw it as a way to regain footing in a market that had proven unprofitable for them.
Critics contend, however, that easing the use of short-term plans is one more blow to the ACA, giving consumers a way to opt out of the standard health plan marketplace. That leaves only the sickest and costliest consumers in those plans, they say, and only worsens the existing problem of high premiums and deductibles. The possibility of such a result was why the Obama administration limited the plans in the first place.
That impact may be limited, however, says Christopher Holt, director of healthcare policy with the American Action Forum, and independent think tank in Washington, D.C.
"The price point attractiveness of these plans is going to be limited to people who aren't getting subsidies," Holt says. "Currently we're at about 10.5 million people on the ACA exchanges and about 85% of those people are subsidized. So, it's not a huge population in the exchanges who would find this very attractive."
Gregory A. Freeman is a contributing writer for HealthLeaders.