Short-term insurance plans are another assault on ObamaCare

Short-term insurance plans are another assault on ObamaCare
© Hill Photo Illustration/Garrett Evans

In yet another carefully orchestrated move to sabotage the Affordable Care Act, President TrumpDonald John TrumpOver 100 lawmakers consistently voted against chemical safeguards: study CNN's Anderson Cooper unloads on Trump Jr. for spreading 'idiotic' conspiracy theories about him Cohn: Jamie Dimon would be 'phenomenal' president MORE last Tuesday unveiled a proposal that would significantly loosen restrictions on short-term health insurance plans.

It is part of a concerted strategy to divide the market by encouraging healthy individuals to splinter off from the general risk pool, thus making ObamaCare completely unsustainable.

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It is the latest in a campaign he began last October when he signed two executive orders to methodically dismantle Obama's signature health care law.

 

One order ended cost-sharing reductions (CSRs), which were government subsidies that once helped low-income Americans obtain affordable health insurance on the individual market and paid for certain deductibles and out of pocket costs.

Eliminating these payments effectively drove up insurance premiums on the individual market and priced some customers out of the health insurance pool.

Trump's other executive order expanded the use of Association Health Plans (AHPs). Similar in concept to employee credit unions, in which employees pool together resources to form their own bank, these AHPs are health insurance plans offered by a group of small employers who band together to form their own insurance pool for their employees.

The only problem here is that the AHPs are exempt from many of the rules and regulations traditional insurance plans must follow under the Affordable Care Act. AHPs can therefore be selective in which customers are eligible to enroll, which often means only healthy, young employees need apply.

Of course it hasn't stopped there. On December 22, 2017, President Trump signed into law the Tax Cuts and Jobs Act, which included within its provisions a repeal of the individual mandate starting in 2019.  

The mandate tax penalty is a safeguard preventing healthy individuals from choosing not to enroll in a health insurance plan. One of the only ways to have a health care system that that treats patients with preexisting conditions, chronic illnesses, and the truly vulnerable is if all participants stand together united.

That means the young and the old, the healthy and the sick, and the lucky and the unlucky alike must be in the same risk pool. Doing so benefits everyone because every single person will end up in one of those categories eventually. Nobody stays young and healthy forever.

But now in his latest salvo on Tuesday, President Trump seeks to further peel away healthy individuals from the general health insurance pool, leaving only the sickest individuals behind. Short-term insurance is a type of cheaper health insurance that is exempt from many of the minimum requirements under the Affordable Care Act.

For instance, these insurance plans are not bound by the rules governing pre-existing conditions, and can either charge more or totally disallow any type of individual from signing up. They have no minimum coverage requirements and may cover almost nothing at all for any major hospitalization or surgical procedure.

Deductibles and out of pocket costs can be as sky high as having no insurance at all. In other words, they are what many experts are calling "junk insurance" plans. It's like having car insurance that doesn't cover anything except for giving you a proof of insurance card.

Previously under ObamaCare, the maximum time an individual could carry a short-term insurance plan was three months. It was meant to be the most temporary of stop gap measures for individuals in between jobs or insurance plans. Now President Trump is increasing that time to 364 days. Newly appointed Health and Human Services Secretary Alex M. Azar II is even exploring ways to extend that time further.

On Tuesday he extolled the benefits of short-term insurance plans, stating that "Americans need more choices in health insurance so they can find coverage that meets their needs." It is truly ironic that the very person tasked with stewarding the health care of all Americans is using his position to dismantle it.

The true goal of expanding short-term insurance is to lure healthy individuals away from plans on the ObamaCare exchanges. With only the sickest customers left on the exchange, insurance companies would have increasing incentives to either raise premiums to a prohibitive level or leave the exchanges entirely.

President Trump and the Republican Party, failing to outright repeal the popular Affordable Care Act, are now engaged in a gradual, insidious campaign to dismantle the very foundation of the health care law brick by brick. It is an effective strategy because each little paper cut escapes the notice of the general public until all the blood is gone and our country's health is exsanguinated.

Dr. Eugene Gu is a resident physician at the Vanderbilt University Medical Center and president of the Ganogen Research Institute. He graduated from Stanford University with honors and holds an M.D. from the Duke University School of Medicine.