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Heart on the Hill - August 2018

Administration Chips Away at the Affordable Care Act

This summer, the administration finalized several proposed rules that expand access to subpar insurance policies. These plans contain fewer patient protections than the options offered by the Affordable Care Act (ACA), including several that are important to patients with cardiovascular disease. These include the ten essential health benefits, bans on annual and lifetime limits and caps on out-of-pocket costs.

On August 1, the Department of Health and Human Services released the final version of its controversial rule on short-term, limited duration (STLD or short-term) plans. This new rule expands the availability of STLD plans from three months to one year. It also gives consumers the option to renew these plans. Despite broad and strong opposition from almost all healthcare stakeholders, including hospitals, providers, patient groups and insurers, the administration moved forward with few changes to the original rule.

Short-term policies are not required to provide comprehensive coverage, including hospitalization, emergency room visits, preventive care, prescription drugs, maternity coverage and many other essential services. These polices have a history of retroactively rescinding coverage, or denying it, which can cause high rates of medical bankruptcy, and leave consumers’ lives and finances in jeopardy. In addition, healthier individuals tend to select these plans causing premiums to rise significantly for those with preexisting conditions that require more comprehensive coverage.

The potential impact on patients with heart disease and stroke is significant. Individuals who choose these plans could be left out in the cold if their insurer decides that their cardiovascular event was “preexisting” and those left on the exchange could be priced out of coverage altogether. To help protect our patients, the association, in conjunction with more than 30 patient and provider advocacy partners, will turn their attention to regulating these plans through state legislatures.


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