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Repeal & Replace Watch

Demand For Popular Short-Term Insurance Plans Could Surge If Health Law Is Relaxed

Short-term health plans have been around for decades, bridging coverage gaps for people who are between jobs or have recently graduated from school, among other things. After the health law passed, some people gravitated toward them because they were willing to trade comprehensive coverage for a cheaper sticker price 鈥斅爀ven if it meant paying a tax penalty for not having the comprehensive coverage required in the law. .

Now, as Republicans look for ways to weaken the health law鈥檚 coverage requirements and explore the possibility of not enforcing the requirement that people have health insurance, short-term plans may be poised to grow even more. If that happens, consumer advocates warn it could be bad for consumers.

As their name suggests, short-term plans provide coverage for a limited period of time, often six months or less. They generally don鈥檛 cover such things as preexisting conditions, maternity services or prescription drugs. The policies typically have maximum coverage limits of about $1 million. Insurers can turn people down if they鈥檙e sick and may decide not to renew someone鈥檚 policy. All of that qualify as individual insurance under the Affordable Care Act.

Precisely because of these limitations, however, the premiums are typically a lot cheaper than those for ACA-compliant coverage. In the fourth quarter of 2016, the average monthly premium a shopper would pay for a short-term plan sold through online insurance vendor was $124, compared with $393 for someone who bought a regular Obamacare plan and didn鈥檛 qualify for premium subsidies.

When the health law passed, short-term plans that stretched the definition of 鈥渟hort,鈥 sometimes providing coverage for as long as 364 days.

鈥淐arriers were exploiting a loophole in the law that defined a health insurance plan as one that was 365 days,鈥 said Sabrina Corlette, a research professor at Georgetown University鈥檚 Center on Health Insurance Reforms. 鈥淚f they were shorter they didn鈥檛 have to comply with ACA protections.鈥

Short-term plans serve a tiny but growing proportion of the who have coverage on the individual market. At the end of 2013, before the health law鈥檚 major reforms took effect, there were approximately 108,800 people covered by these policies, which earned premiums of $97.5 million, according to figures from the National Association of Insurance Commissioners.聽, roughly 148,100 people had short-term plans and premium earnings have grown to $160.5 million.

Some insurers have taken notice. Online health insurance vendor 听濒补耻苍肠丑别诲 聽in the spring of 2015 to focus on sales of short-term plans. In the third quarter 2016, Agile sold 21,000 short-term policies.

鈥淭hese short-term plans are not regulated like Obamacare plans, so carriers have a lot of flexibility in benefits and pricing,鈥 said Sam Gibbs, Agile鈥檚 executive director. 鈥淚t鈥檚 almost like the old individual market before the ACA.鈥

And that鈥檚 just the problem, said some policy experts.

time clock short term plan鈥淭o many consumers it looks like health insurance, except it鈥檚 cheaper,鈥 said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. But the plans don鈥檛 protect people when unforeseen events occur such as a car accident or a cancer diagnosis. With a short-term plan, if you get sick or you鈥檙e in the hospital when your plan comes up for renewal, 鈥渋t won鈥檛 be renewed,鈥 Pollitz said.聽(KHN is an editorially independent program of the foundation.)

Not all insurers embrace widespread sale of short-term plans. 鈥淭he big health insurance companies are really mixed on this,鈥 said Timothy Jost, emeritus professor at Washington and Lee University School of Law and an expert on the health law. 鈥淭hey see this as a seriously destabilizing force in the market, this crap coverage.鈥

Last October, the Obama administration 聽that would make it more difficult for consumers to buy short-term plans to substitute for regular Obamacare plans. The regulation, which takes effect April 1, said short-term plans must be less than three months in duration. People can request a renewal of the policies, but insurers can turn them down. The policies and related materials also have to prominently display a warning that they don鈥檛 satisfy the law鈥檚 requirement that people have health insurance.

Some hope that the rule may be changed or rescinded by the Trump administration or overturned by the new Congress under the little-used .聽Neither option can happen at the stroke of a pen, however.

Health insurance brokers and agents are one group that would like to continue to sell longer term short-term plans.

鈥淥ur folks do a lot of business with short-term plans,鈥 said Marcy Buckner, vice president of government affairs at the National Association of Health Underwriters, an industry group. The regulation is one that the group will request that the Trump administration rescind.

鈥淚n most areas [a short-term plan] is cheaper, and it鈥檚 some consumers鈥 way of saying, 鈥業 don鈥檛 need all of those things,鈥欌 said Buckner.

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