Seven patient advocate and health care groups are suing the Trump administration for expanding short-term limited duration plans, cheap health insurance with a history of discrimination.
These groups — representing patients, providers, and insurers — accuse the Trump administration of jeopardizing health care for the most vulnerable, as these short-term plans can skirt consumer protections outlined in the Affordable Care Act (ACA) and deny people with pre-existing conditions or charge them more. Indeed, roughly half of these plans do not cover services for mental health or addiction treatment and none cover maternity care. And many people with HIV are generally denied coverage entirely.
The Obama administration only permitted people to purchase these plans for up to three months, as they were only intended to cover people who, for example, are in between jobs. But, in August, the Trump administration issued a final rule, allowing people to purchase these plans beginning October 2nd for up to one year and renewable for three. This rule was largely unpopular; in fact, 335 of 340 formal comments criticized it, according to the Los Angeles Times.
“At a time when suicide and overdose deaths have hit epidemic levels and continue to rise, the last thing we need is a rule that confuses consumers and offers worse mental health and substance use benefits,” said Paul Gionfriddo, president and CEO of Mental Health America, in a statement. “The [short-term] rule not only violates the intent of Congress in the ACA, it also rips away needed treatment and threatens the lives of countless Americans.”
The groups suing include the Association for Community Affiliated Plans (ACAP), National Alliance on Mental Illness (NAMI), Mental Health America, American Psychiatric Association (APA), AIDS United, National Partnership for Women & Families, and Little Lobbyists.
They argue that a federal judge should block the expansion of short-term health plans for various reasons, including that they contradict the very definition of “short-term,” with the Trump administration arbitrarily reversing previous limits that Congress did not authorize and violating current health law. Legal expert Nicholas Bagley said on Twitter that this lawsuit “has legs” — unlike anti-ACA litigation currently making its way through the courts.
Moreover there are real-world consequences, they argue. They cite one woman in Illinois whose short-term plan didn’t cover her five-day hospital stay and hysterectomy because her menstrual cycle constituted a pre-existing condition.
“This rule is not merely harmful policy — it is unlawful,” write the plaintiffs.
The lawsuit, filed in a Washington D.C. federal court, aims to mitigate harm done to President Barack Obama’s signature health law since Donald Trump took office. Because Congress failed to repeal the ACA last year, the Trump administration has used its executive power to unravel it instead — but it largely hasn’t worked. And perhaps Trump’s most influential health policy, Medicaid work requirements, has also been met with lawsuits.
Short-term health plans might finally be the policy to do the most harm to the ACA marketplaces, which have faired well so far despite all the ways Trump has scaled back current health law within his first year. Even the administration says as many as 200,000 people would stop purchasing ACA-compliant plans and instead buy short-term plans. And outside experts agree.
“Lengthening the maximum allowable duration of short-term, limited-duration insurance, especially in conjunction with the elimination of the individual mandate penalty, will likely lead to some younger and healthier individuals moving away from ACA-compliant coverage and opting for short-term coverage,” wrote American Academy of Actuaries senior health fellow Cori Uccello in August. “Higher ACA premiums will result.”
The Urban Institute estimates premiums will increase upwards of 10 percent on average.