By Peter Johnson
A Trump administration rule expanding the availability of short-term, limited duration (STLD) health insurance plans will continue after an appeals court panel ruled 2-1 against a suit brought by the Association for Community Affiliated Plans (ACAP). A July 17 statement by ACAP CEO Margaret Murray suggests the trade group for safety net health plans is likely to continue pursuing the case.
STLD plans don’t have to comply with Affordable Care Act requirements mandating plans cover things like outpatient drugs, behavioral health care and maternity care, and they don’t have to offer the ACA’s protections for people with preexisting conditions. The court, in an opinion written by Judge Thomas Griffith, agreed with ACAP’s argument that STLD plans are of lower quality than ACA-compliant plans, but said the government has “wide latitude” to define what STLD plans are permissible.
In its lawsuit, ACAP argued that allowing such plans to exist was driving membership declines in ACA-compliant coverage. The trade group lost at the district court level before appealing to the D.C. Circuit Court.
According to a July 17 Health Affairs blog post by Katie Keith, a health care lawyer and principal at Keith Policy Solutions LLC, studies by the House Energy & Commerce Committee, Kaiser Family Foundation and CMS have all found that “the sale of [STLD plans] raises premiums for people with preexisting conditions who purchase coverage in the ACA markets.”
However, Joseph Antos, a resident health care scholar at the right-leaning American Enterprise Institute, argues that the impact of STLD plans on the health insurance market at large is overstated. He observes that STLD plans are mainly appealing to people who earn too much to qualify for ACA premium subsidies but don’t have a viable employer-sponsored insurance option.
“The only people who have really left the exchanges market are the people who didn’t get very substantial premium subsidies,” he tells AIS Health.