ACA At Risk: Is Coverage for Pre-Existing Conditions Next?

August 22, 2018

On September 5th, a judge will hear oral arguments in a lawsuit filed by a number of states, led by Texas, arguing that the ACA should be made invalid.

This is one of many attempts by the Trump Administration and the Republican majority in Congress to undermine the ACA and the protections that millions of Americans depend upon. Should the plaintiffs win the lawsuit, Americans with pre-existing conditions may lose their access to affordable healthcare, ending a critical protection offered by the ACA that, among others, would end.

The ACA has been attacked on multiple fronts – from enrollment to insurers to the overall marketplace.

Slashing Funding for Open Enrollment

Open enrollment is the period during which Americans can enroll in a health plan on the individual market. President Trump and Congress have made it harder than ever for Americans to enroll.

• The enrollment period has been cut in half, from three months to just six weeks.
• Funding to advertise open enrollment season has been cut by 90 percent.
• Funding for “navigators” who help people sign up for healthcare has been cut to just $10 million from $63 million two years ago.

Without adequate funding, fewer people may enroll in health insurance. This increases the number of uninsured and perpetuates the argument that the individual marketplace doesn’t work.

Ending Subsidies

The Trump Administration ended critical funding to insurers who offer healthcare to lower-income Americans.

As a result of ending these “cost-sharing reduction” (CSR) payments in 2017, premiums have continued to increase.

Expanding Junk Plans

Over the past several months, the Trump Administration has broadened eligibility and access to “junk plans” that are cheaper than traditional healthcare but offer very limited coverage.

• Short-term plans will be extended from three months to 12-month periods, with the option of renewal. They do not offer the 10 essential benefits that the Affordable Care Act requires, such as maternity care and prescription drugs. (New York State prohibits short-term plans.)
• Association Health Plans (AHPs) will allow more businesses to band together and offer cheaper health insurance plans that also are not required to provide the 10 essential benefits the Affordable Care Act requires.

The low premiums these plans offer will entice healthier Americans to leave the individual marketplace, leaving sicker Americans stuck with ultimately higher premiums.