Appeals court upholds Trump administration expansion of short-term health plans

07/18/2020 Health


The lawsuit, brought by a coalition of nonprofit insurers selling plans in Affordable Care Act exchanges and by patient assistance groups, focuses on administration extending the duration of the plans to short term to just under a year, rather than three months. The rule, which was issued in 2018, stems from an executive order that President Donald Trump signed the previous year.

Short-term plans, which have been available for years and were originally designed to fill a temporary gap in coverage, are usually cheaper than Obamacare’s policies. But that’s because they are allowed to exclude those with pre-existing conditions and base fees on the applicant’s medical history, unlike Obamacare’s plans.

Opponents of these policies say they could harm patients who need coverage and could affect the Affordable Care Act markets by driving healthier consumers away from exchanges and increasing premiums for those who stay.

But in a 2-to-1 decision, the appeals court said it was not convinced by arguments that the rule that expands short-term plans is contrary to law and arbitrary and capricious.

“Congress certainly expected most people to purchase ACA compliant plans as their primary insurance, and offered incentives to encourage them to do so. But it did not exclude other options,” judges Thomas Griffith and Gregory Katsas said, confirming The rule, he wrote in his decision.

Dissident Judge Judith Rogers said the rule “contradicts” Congress’ plan for the Affordable Care Act “by expanding a narrow legal exemption beyond recognition to create an alternative market for primary health insurance. that is exempt from comprehensive coverage of the ACA coverage requirements and fair access. “

Margaret Murray, executive director of the Association of Community Affiliate Plans, the lead appellant, said the group will ask the entire DC circuit to hear the case.

“As long as junk insurance plans are allowed to compete directly with comprehensive insurance plans that comply with the Affordable Care Act, the ACA health care protections, and the consumers who trust them, are in danger, “he said in a statement. statement.

The Democrats-led House Energy and Commerce Committee released a nearly 200-page report last month that found enrollment in short-term plans increased by 600,000 last year to 3 million policyholders in nine companies examined . Furthermore, these policies often leave people burdened with thousands of dollars in medical debt because they do not provide comprehensive coverage, according to the report.

The Department of Health and Human Services called the decision a great victory.

“Thanks to the president’s actions and decision today, millions of Americans can access affordable short-term insurance plans that may make sense for their needs,” said Michael Caputo, the agency’s assistant secretary for public affairs.

A judge in the United States District Court last July also upheld the rule.

The fate of the entire Affordable Care Act is now in the hands of the Supreme Court, which agreed to hear it in his next term. The Trump administration sided with a coalition of Republican attorney generals, who argue that Congress’s reduction of the individual mandate sanction to $ 0 has made the mandate unconstitutional. And invalidating it should void the entire law, including protections for people with pre-existing conditions.
A federal appeals court in December agreed with a lower court ruling that the individual mandate is now unconstitutional, but the judges imposed on the lower court the decision on whether that means the entire law should fall. The United States District Court judge reversed the entire law in December 2018.

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