The Trump administration has always seen Obamacare as an abominable roadblock to the less regulated insurance market it prefers. Last year,
it tried to knock it down and failed.Find the more
health news from SHINE. More customers who want to avoid buying health insurance can now find a way out of the law’s individual-mandate penalty, which will disappear completely next year. Those who want skimpy plans
not covering maternity care or bills exceeding a set annual amount may
soon have that option in many states — provided they don’t have
pre-existing conditions. Obamacare’s many rules about insurance — meant to make coverage accessible to Americans regardless of
their health status, and comprehensive enough to cover their needs —
still exist. Obamacare plans will still have to cover a basic set of
health benefits and accept customers who have a history of illness. But,
through a series of regulatory maneuvers, the Trump administration is
making the insurance market governed by those rules increasingly
optional. Alongside the Obamacare market it couldn’t destroy, it is
helping to build a second market, free of many rules, and more like the
market that Obamacare replaced. On Monday, the Centers for Medicare and Medicaid Services, which oversees the marketplaces,
unveiled a series of policies that Seema Verma, the agency’s
administrator, made clear were aimed at working around the health law’s
requirements. Americans shouldn’t be punished by its failure to provide
choices,” she said, referring to the Affordable Care Act. “Until the law
changes, we won’t stand idly by as Americans suffer.” Rules and other
guidance released Monday provide some ways out. People who live in a
county where only one insurer offers Obamacare-compliant health plans
now can get an exemption to the law’s individual mandate penalties right
away. (They’ll go away for everyone next year under legislation passed as part of the tax overhaul.) The administration is
allowing older plans that predated Obamacare and that don’t follow all
its rules to stick around another year. It’s also allowing health plans
to cover a slightly less robust set of benefits, although those changes
are mostly marginal. Bigger changes are coming. The administration has
proposed regulations that would allow so-called short-term health plans
to be offered for nearly a year of coverage. Those plans aren’t subject
to any Obamacare rules in most states, and are likely to be marketed
aggressively. They are likely to cover fewer health services and be
available only to the healthy — but at a lower price. Another pending
rule would expand the availability of association health plans, a form
of group insurance purchasing that may be attractive to small businesses
looking for cheaper, less comprehensive options. It’s hard to predict
precisely who will choose what. The administration wrote in its rule proposals that it didn’t anticipate either the short-term or
association plans to be very popular, even as it lauded them as
important alternatives to the current options under the health law. The
new options may mostly attract people who are uninsured now, because
they were priced out of the current market. Outside experts think the
alternatives could siphon away a substantial percentage of healthy
people from the Obamacare markets.
