Opinion | Biden is quietly reversing Trump’s sabotage of Obamacare

Slowly but surely, President Biden is repairing the US healthcare system, reversing the Trump-era sabotage and ensuring millions more Americans have access to affordable coverage.

The latest of those efforts came on Friday, with a little-known but significant decision to protect Americans from junk health insurance.

In 2017, Congress made repeated unsuccessful attempts to repeal the Affordable Care Act. To the casual observer, it might have looked like the end of the Republican fight to kill off this lifesaving, inequality-fighting, and recently popular law. It wasn’t. In the years since, President Donald Trump has found new ways to sabotage the health care system and its protections for the most vulnerable Americans.

Among the most insidious of these backdoor repeals: expansion short-term, time-limited health plans, e.g to dupe Americans into plans that looked cheap but in practice covered nothing.

Short-term plans are theoretically intended as a short, let’s say interim cover, to cater for a recent graduate whose work doesn’t start until the autumn.

They are relatively unregulated; for example, they don’t have to cover the minimum benefits guaranteed by Obamacare and other important laws. A 2018 analysis found that most do not cover maternity services, substance abuse treatment or prescription drugs.

The Post’s point of view: Obamacare is working. Democrats need to make sure it lasts.

These plans may also deny coverage for treatment of pre-existing conditions, even if the pre-existing condition is in question had not yet been diagnosed at the time of enrollment of the person.

People often don’t realize they’ve bought a worthless product until it’s too late when they’re hit by a bus, say, or diagnosed with a brain tumor.

Such loopholes might seem like a big deal until you find yourself falling through one. The Trump administration made sure more people did so by allowing these supposedly short-term plans to last up to 364 days, rather than the three-month maximum that had been in place, and to be renewed for up to three years.

This made them look very similar to regular pianos. Also, because short-term plans are extremely lucrative for insurers, brokers can get much higher commissions for referring hapless customers to them. So, many did.

It’s not clear exactly how many were enticed by this policy change; the data is bad, precisely because these products are so unregulated. A recent estimate by the Urban Institute puts the number of people enrolled in individual plans that do not comply with Obamacare protections at 2.5 million.

The proliferation of short-term junk plans also affects consumers who aren’t duped by them. That’s because these cheaper plans disproportionately crowd out the healthier (i.e. low-cost) people out of the larger individual insurance markets. People who have chronic illnesses or who otherwise know they need more substantial coverage are more likely to stay in the regular market pool, driving up premiums there.

Last week, however, the Biden administration announced a rollback of this expansion of Trump-era short-term health care plans.

In a proposed rule, Biden officials said those already part of these succinct Trump-blessed plans can continue with them if they choose. (There were some hard lessons learned from the “if you like your plan you can keep it” a decade ago, speculates Georgetown University health scholar Sabrina Corlette.) But going forward, any new short-term, limited-life plan should to be Truly short-term (up to three months) e Truly limited duration (only renewed for an additional month).

Crucially, short-term plans also need to provide clearer language about what care they do and don’t cover, and under what circumstances. People who choose to buy junk need to know in advance that they are buying junk.

The White House has marketed this rule as part of Bidenomics, even though it could more easily be understood as simply pro-consumer. It also dovetails nicely with other actions the administration has taken to expand access to coverage, including raising awareness to encourage eligible Americans to enroll in market plans and correcting the so-called household glitch (a regulatory crash that had stalled many families access to subsidized benefits Health coverage).

More importantly, through last summer’s Inflation Reduction Act, Biden extended the improved premium tax credits available for plans to the individual market.

This has meant that millions more Americans can get robust health care coverage that is not only affordable but, in many cases, also has an out-of-pocket premium of zero dollars. And unlike those junk insurance plans, the low price here isn’t a red flag; these plans actually provide comprehensive coverage, even for people with pre-existing conditions.

It’s not a bait and switch. It’s a real subsidy, and one that will likely reduce premiums overall, on average, by drawing healthier people into the broader risk pool in the market.

Our healthcare system is still clumsy. It still allows too many Americans to fall through the cracks. But small, unsung fixes like this are achievements worth celebrating.

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