Last week President Trump made a number of announcements related to health insurance policy. First, he signed an executive order that seeks to increase competition by facilitating access to association health plans, short-term limited duration insurance products, and health reimbursement arrangements. Nothing is changing immediately; rather, the president has directed several government agencies to draft regulations to implement new policies over the next 60 to 120 days. Experts disagree about whether and how these policies can be implemented via regulation, so it is not yet clear what the effects of these new policies may be. Since association health plans and short-term insurance products do not need to follow a number of ACA patient protections, they could appeal to younger, healthier people who seek skimpier, less expensive coverage. This would raise costs for many of the people our members treat who need comprehensive coverage.
President Trump also announced that the White House will discontinue making cost-sharing reduction (CSR) payments to health insurance companies that subsidize out-of-pocket costs for low-income people. Plans in a number of states have increased premiums in anticipation of the CSR payments stopping, but the biggest risk for consumers is that insurance companies will drop out of marketplaces for next year. Already 15 states and the District of Columbia have filed lawsuits to ensure that the payments continue, so it is also unclear whether this change will take effect.
The combined effect of these policies adds further uncertainty to the health insurance market, where insurers and individuals are preparing for the start of open enrollment on November 1. These actions also add new pressure for Congress to pass bipartisan legislation to stabilize health insurance markets.
The Society will be closely monitoring regulations to implement the executive order and potential legislation in Congress regarding insurance markets. We will continue to advocate for access to comprehensive, quality insurance for patients and will provide an update as more information on the impact of these changes becomes available.