Health Affairs - The Supreme Court Protected The ACA. Now, Let's Protect Americans From Junk Insurance Plans

Op-Ed

By Tammy Baldwin and Chris Murphy

Never before has health insurance mattered more to Americans. Our nation has been shaken to its core by a pandemic that has taken over 600,000 lives. But the toll of the pandemic cannot be quantified by the death toll alone. That's because right now, thousands and thousands of people who contracted the virus months ago are still suffering. These "long-haulers" live with severe headaches, constant nausea, brain fog and other after-effects. We are still learning about the long-term prognosis of a COVID diagnosis, and researchers and clinicians are hard at work trying to find answers.

Unfortunately, in every crisis there is a profit opportunity. And for companies selling junk insurance plans, a COVID diagnosis is now a new pre-existing condition that can be used to deny someone health care coverage or to charge them more than others.

The Affordable Care Act has been on the books since 2010. And for the first time in a decade, there is no Republican Congress trying to repeal it, no Republican Attorneys General suing in court to overturn the entire statute, and no Republican president trying to sabotage the law. This is cause for celebration, but it is no time to relax. Rather, we have a short window of time to reverse a decade of debilitating attacks on the Affordable Care Act.

During the Trump administration, we saw a barrage of Republican assaults on our health care system. One particularly damning move was an effort to scale back consumer protections in the Affordable Care Act. In 2018, the Trump administration expanded junk insurance plans, also known as short-term, limited-duration insurance plans. Insurance companies promoted these plans for their affordability. But these plans are cheap for a reason.

One of the primary reasons why junk insurance plans are so inexpensive is that they don't have to cover pre-existing health conditions. And they don't have to cover prescription drugs, mental health or substance use disorder treatment, maternity care, and a host of other basic needs. Too often, they leave consumers stuck with a stack of surprise medical bills. Of course, you have to read the fine print to understand how limited these junk insurance plans really are. No junk insurance company openly advertises the fact that their coverage can leave people with pre-existing conditions out in the cold, and too often these companies actively mislead consumers.

Before the Trump administration changed things, these short-term plans were only available to consumers to temporarily fill a gap in coverage while persons changed from one job to another. They were short-term. But the Trump administration made them available for up to 364 days in duration and renewable for up to three years. Then to add insult to injury, the Trump administration required navigators, as a condition of federal funding, to promote junk insurance plans as an alternative to Affordable Care Act-compliant plans in the Marketplace and urged states to follow suit.

Without immediate action, Americans may unwittingly buy these inadequate plans during the next Open Enrollment Period. And those with COVID histories may buy a plan that refuses to cover them for any expenses related to that condition. Think about that for a second: individuals who contracted the coronavirus--from those who were asymptomatic to those who went through the scary and harrowing experience of a COVID diagnosis--will be victimized again when they find out that the fine print of their insurance plan denies them the follow-up care they need. That's outrageous.

The good news is that a bill from Congress is not necessary. The Biden administration can fix this by taking action, but their window is short to close Trump's loophole that allowed junk insurance plans to flourish. To make sure that these plans don't flood the marketplace for the next Open Enrollment period, the administration needs to roll back these junk plans before the fall.

Let's right this wrong. Let's end the health care sabotage of the previous administration and get more people enrolled in affordable, comprehensive health insurance.

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