Democrats this week hoped Alaska’s U.S. Sen. Lisa Murkowski would come through for them on health care once again, appealing to her moderate politics on a vote to block the Trump administration’s expansion of short-term health insurance plans.
Despite a direct appeal from Sen. Tammy Baldwin to Murkowski and Maine Sen. Susan Collins, Murkowski ultimately voted against the resolution that would have blocked a Trump regulation to extend the length of time people can stay on the cut-rate health insurance plans.
The short-term health insurance plans don’t have to cover the same things that plans on the individual marketplace have to cover, like pre-existing conditions, prescription medicine or pregnancies. They were first introduced under the Obama Administration in 2016. Under that rule, they were limited to three months and meant as a stopgap for people between jobs. The Trump rule extends them to a year and allows, but doesn’t require, insurance companies to sell them up to three years.
Collins voted in favor of blocking Trump’s change, leaving it with a failing 50-50 vote. Alaska U.S. Sen. Dan Sullivan was among the remaining Republicans voting with the Trump administration.
Democrats were scathing in their assessment of these short-term health insurance plans, with Senate Minority Leader Chuck Schumer calling them “junk” and an attempt to “sabotage the marketplaces, jack up costs and premiums for millions of middle-class Americans.”
The fear is that many young, healthy people would opt for the cheaper plans, shrinking the number of people participating in the individual marketplaces even further after Republicans—Murkowski included—voted to repeal the individual mandate as part of last year’s tax cuts.
Murkowski defended her vote in context of Alaska’s highest-in-the-nation health care costs. Consumers aren’t forced into the discount plans, she said, it’ll be a choice.
“They’re looking for additional options but they’re looking for affordable options, as well. And it is true, absolutely true, that the short term plans do not offer as much, or certainly may not offer as much, in the way of coverage, as those plans that are offered on the individual exchanges,” she said. “But I have had to come down on this issue on the side of more choice for consumers, more options, being a good thing for consumers.”
The reality is that the impact of the short-term health insurance plans, in Alaska at least, has been relatively minimal. Alaska Division of Insurance Director Lori Wing-Heier said in an email that fewer than 100 Alaskans currently use the short-term health plans though she expects it to grow some.
“However, we do not expect a recognizable impact on individual health insurance market participation,” she said. “Ninety percent of the Alaskans currently enrolled in the individual market receive federal subsidies to help cover premium costs; the remaining 10 percent of enrollees who pay the full premium are not likely to switch to a short-term, limited duration plan with more limited coverage.”
The Alaska Division of Insurance previously warned Alaska consumers to be careful when considering short-term health plans when they were first introduced under the Obama administration. Wing-Heier said much hasn’t changed since then when it comes to the plans.
“Consumers need to be aware that these are not comparable to the bronze or silver plans – most do not provide a pharmacy benefit, maternity, behavioral health and they may contain a cap for cancer, etc, if they do not determine that it is a pre-existing condition,” she said.
She added, however, that the rules under the Trump administration do give states greater power in regulating the plans, which is something she said the state is currently considering.
“The other consideration between the plans as they were allowed under the prior administration, is that the new rule issued by Centers for Medicare and Medicaid Services provides the state with the ability to closer regulate these plans to protect consumers,” she said. “The Division of Insurance is currently reviewing our statutes/regulations to determine what we may need to change to protect consumers. Other states are doing the same.”
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