NEW REPORT: Senate GOP-Backed Junk Insurance Plans That Can Exclude Pre-Existing Conditions Coverage “Force Many to Pay for Lifesaving Treatments”

On the same day that Republicans are filing briefs in support of the Supreme Court lawsuit to dismantle the Affordable Care Act, a new report from the House Energy and Commerce Committee reveals that short-term junk health insurance plans supported by Senate Republicans “force many to pay for lifesaving treatments,” “often exclude coverage for pre-existing conditions,” and “charge women more for the same coverage.” According to the Wall Street Journal, the review of consumer complaints against insurers “found numerous examples of patients who were denied coverage for treatment, leaving consumers on the hook for hundreds of thousands of dollars.”

Vulnerable incumbent Senators Martha McSally, Cory Gardner, Steve Daines, David Perdue, Joni Ernst, Mitch McConnell, Thom Tillis, Lindsey Graham, and John Cornyn all failed a critical “litmus test for anyone who claims to support protecting people with preexisting conditions” by voting to defend the expansion of these junk plans, which are “so skimpy that they offer no meaningful coverage” and can leave patients saddled with “catastrophic costs.” 

The White House is pushing these junk plans for people who have lost their health insurance as a result of the pandemic — despite the fact that these plans aren’t required to cover testing or treatment for COVID-19. Senate Republicans are also refusing to press the Trump administration to open a special enrollment period for health insurance and have “no plan” to help the newly uninsured get coverage.

Wall Street Journal: Shorter-Term Health Plans Force Many to Pay for Lifesaving Treatments, Report Finds
By Stephanie Armour

Key Points:

• Many consumers have been forced to pay for their own lifesaving treatment under shorter-term health plans that have seen enrollment jumps since the Trump administration relaxed restrictions on them, according to a report to be released Thursday by House Democrats on the Energy and Commerce Committee.

• The short-term plans don’t have to comply with the 2010 Affordable Care Act, so they often exclude coverage for pre-existing conditions and charge women more for the same coverage, the yearlong investigation found.

• These plans have proliferated since August 2018 when the Department of Health and Human Services issued a rule expanding access, one of the most significant steps to undercut the ACA after GOP lawmakers in Congress failed to repeal it in 2017.

• In its review of consumer complaints against insurers selling short-term plans, the committee reported that it found numerous examples of patients who were denied coverage for treatment, leaving consumers on the hook for hundreds of thousands of dollars.

• “Coverage limitations vary greatly from plan to plan and insurer to insurer, and limitations are not made clear in marketing materials, making it extremely difficult for consumers to understand what they are purchasing,” according to a summary of the report.

• The committee’s investigation found that, on average, less than half of the premium dollars collected from consumers are spent on medical care, unlike ACA-compliant individual market plans, which are required to spend at least 80% of all premium dollars on health care. The rest of the money generally goes to administrative, overhead and marketing costs.

• But the committee review found it is common industry practice for short-term plans to engage in administrative processes to avoid paying medical claims. Through a process some have described as “post-claims underwriting,” insurers challenge consumers whose claims may actually be covered by the terms of the plan by requiring them to submit extensive medical documentation often dating back many years to prove their condition wasn’t pre-existing.

Read the full story here.

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