The American Hospital Association said it supports CMS' plan to limit short-term "junk" health plans but is calling on the government to address other gaps in coverage that subject patients to unaffordable cost sharing.
In July, the Biden administration released a proposal to limit short-term plans to three months — or a maximum of four months, if extended. Short-term plans don't have to cover preexisting conditions and are allowed to bypass the ACA's requirement to cover such services as maternity care and mental health treatment. The Obama administration imposed a three-month limit on the short-term plans, but the Trump administration changed the rules to allow people to stay on the plans for a year and renew coverage for up to three years.
AHA said in an Aug. 28 letter to CMS administrator Chiquita Brooks-LaSure that it has long advocated for limiting the availability of these plans. The organization added that it is "deeply concerned with both the amount and the complexity of patient cost sharing even in ACA-compliant health plans" and would like to see those addressed in future rulemaking.
"One of the most concerning trends is the growth in adoption of high-deductible health plans and the deductible amounts," AHA said in the letter. "These types of products are often marketed — inaccurately — as more cost-effective options for lower income individuals and families. As a result, many people only realize when they need care that their health coverage does not cover as much as they thought, subjecting them to unexpected medical bills. This can create [undue] financial and emotional stress and contributes to medical debt. We urge the agency to take steps to simplify cost-sharing structures and reduce the amounts owed out of pocket."
AHA also said it is increasingly hearing reports of commercial payers implementing convoluted policies — such as mid-year coverage changes, excessive application of prior authorization, and complex cost-sharing and network structures — that leave patients unsure of whether their care will be covered.