Fed
up with failed attempts in Congress to repeal the Affordable Care Act,
President Trump on Thursday took matters into his own hands, signing an executive order that could significantly damage the health insurance market and harm millions of people.
Mr.
Trump directed his administration to effectively create an alternative
health insurance system that does not include the safeguards of the
A.C.A. and could sabotage that 2010 law, one of his predecessor’s
biggest accomplishments. The president claims that this will help people
obtain cheaper insurance. In reality, it most likely will force
insurance companies to abandon the A.C.A.’s insurance exchanges and
ultimately precipitate a collapse of an important part of Obamacare.
The
president is proposing two main changes: to expand the use of
short-term insurance policies and to make it easier for professional and
trade associations to sell health coverage to members across the
country. Officials at the Departments of Health and Human Services, the
Treasury and Labor will now come up with a rule after seeking public
comment over the next several months.
Let’s
start with short-term health policies. The Obama administration put in
place rules that the policies could last 90 days and were not renewable.
They’re currently meant for people between jobs. Mr. Trump is directing
his aides to extend these plans and make them renewable, arguing that
because these policies tend to be cheaper, this change could benefit
millions of people. Short-term plans indeed cost less than yearlong
policies, but that is because they are not as comprehensive. For
example, many do not cover maternity care, cancer treatment or
prescription drugs. And short-term policies often do not pay for
treatment for pre-existing conditions, a signature requirement of
Obamacare policies.
Mr.
Trump also wants to expand the use of association health plans, which
have been around for years but have a terrible track record. These plans
typically work by insuring the employees of small and medium-size
businesses that have something in common. A national plumbers
association, say, might offer a plan to all of its members and their
employees. These plans are lightly regulated by the federal government
and often face little oversight by states because their beneficiaries
are spread out across the country.
Continue reading the main story
ADVERTISEMENT
Continue reading the main story
A 1992 General Accounting Office report
found such plans had left nearly 400,000 members and their
beneficiaries with $123 million in unpaid medical claims between 1988
and 1991. The Trump administration says it will require these plans to
meet some of the requirements of the A.C.A., like protections for people
with pre-existing conditions, but it has provided few details.
The
combined effect of these changes will be to destabilize the A.C.A.’s
individual market, which is used by nine million people to buy health
insurance. Younger and healthier people will be tempted to buy a skimpy
short-term policy with low premiums and switch to a policy that complies
with the A.C.A. only when they need medical care. Knowing that
Obamacare policies will tend to attract older and sicker people,
insurers will probably jack up premiums or withdraw altogether in
sparsely populated counties.
State governments, public interest groups and others will seek to prevent some of the damage from the order.
There is some hope that they will be able to shape the regulations
during the public comment period. If the final rules are still harmful,
some groups will most likely file lawsuits.
But Mr. Trump is determined to disrupt Obamacare.
Before this order, he threatened to stop making subsidy payments to
insurers, which forced many to raise rates for 2018. His administration
has shortened the A.C.A. open enrollment period during which people can
buy coverage for next year. Funding aimed at helping people enroll —
like money for advertising and health navigators — has been slashed.
Congress
must step in. Lawmakers need to finish work on much-talked about
bipartisan legislation to strengthen the A.C.A. America’s long-term
health depends on it.
Follow The New York Times Opinion section on Facebook and Twitter (@NYTopinion), and sign up for the Opinion Today newsletter. NYT
Posts
No comments:
Post a Comment