Health Insurance Coverage Update

Posted Friday, Oct 13, 2017

Yesterday, President Trump signed an executive order that will affect health insurance coverage for Americans. He seeks to increase competition by facilitating access to association health plans (small businesses can join together to purchase insurance coverage through associations), short-term limited duration insurance products (plans that last less than a year), and health reimbursement arrangements (employers can give employees money to purchase insurance rather than provide it directly). Nothing is changing immediately; rather, President Trump has directed several government agencies to draft regulations to implement these new policies over the next 60 to 120 days. Experts disagree about whether and how these policies can be implemented via regulation, so it is not clear what the effects of these new policies may be. Since association health plans and short-term insurance products do not need to follow a number of ACA patient protections, they could appeal to younger, healthier people who seek skimpier, less expensive coverage. This would raise costs for people who need comprehensive coverage.

President Trump also announced yesterday that the White House will discontinue making cost-sharing reduction (CSR) payments to health insurance companies that subsidize out-of-pocket costs for low-income people. Plans in a number of states have increased premiums in anticipation of the CSR payments stopping, but the biggest risk for consumers is that insurance companies will drop out of marketplaces for next year.

The combined effect of these policies adds further uncertainty to the health insurance market, where insurers and individuals are preparing for the start of open enrollment on November 1. These actions also add new pressure for Congress to pass legislation to stabilize health insurance markets, since many in Congress want to fund the CSRs and implement other policies to stabilize the marketplace. ACHA will be closely monitoring regulations to implement President Trump’s executive order and potential legislation in Congress regarding insurance markets. We will continue to advocate for access to comprehensive, quality insurance for adults with CHDs and will update the community as more information on the impact of these changes becomes available.

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