Seven Health Organizations File Appeal Challenging Decision on Junk Insurance Plans
7 Health Organizations File Appeal Challenging Decision on Short-Term, Limited-Duration Junk Insurance Plans
Groups say these inadequate plans undermine consumer protections for people with pre-existing conditions, may discriminate on age, gender or health status
WASHINGTON—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 today filed an appeal in the U.S. Court of Appeals for the D.C. Circuit challenging the recent decision on short-term limited-duration junk insurance (STLDI) plans. On July 19, Judge Richard Leon of the D.C. District Court upheld a 2018 Trump administration regulation allowing the dramatic expansion of the sale of STLDI plans as a direct competitor to comprehensive, Affordable Care Act-compliant health insurance in his ruling in Association for Community Affiliated Plans et al v. U.S. Department of Treasury et al.
This decision allows for the expansion of discriminatory, inadequate short-term “junk” plans, which can set higher premiums based on age, gender, and health status, deny access to basic benefits, lack protections even in the event of a catastrophic accident or illness, and deny coverage for any pre-existing condition. As a recent study from the Georgetown University Health Policy Institute confirmed, the plans are deceptively marketed and “often fail to provide consumers with the detailed plan information necessary to inform their purchase.” Expanding these plans will increase the number of Americans facing unexpected and unaffordable medical bills.
The plaintiffs appealing the decision represent a broad array of insurers, health care providers, and consumer groups that advocate for patients, particularly those with pre-existing conditions and serious illnesses. In filing the notice of appeal, the plaintiffs hope for a swift ruling on the legality of STLDI plans ahead of the 2020 ACA open enrollment period beginning in November.
“We remain firm in our contention that the Trump administration’s decision to expand dramatically the sale of junk insurance violates the Affordable Care Act and is arbitrary and capricious,” said Margaret A. Murray, Chief Executive Officer, Association for Community Affiliated Plans. “Indeed, the district court itself recognized that administration’s decision allows junk insurance to compete directly with comprehensive, Affordable Care Act-compliant insurance plans. That result subverts the health care protections of the ACA. Junk insurance, no matter what it’s called, is an inferior and hazardous substitute for comprehensive coverage.”
“This ruling directly contradicts the Administration’s stated goal of ending the HIV epidemic by 2030 and will return us to the days of discrimination against people living with HIV and other pre-existing conditions,” said William McColl, Vice President for Policy and Advocacy, AIDS United. “If upheld, this ruling will disrupt state marketplaces, impeding the ability of people living with HIV to lead longer, healthier lives and potentially resulting in increased cases of HIV. This dangerous ruling must be overturned on appeal.”
“This ruling will allow insurance plans to deny coverage for pre-existing conditions,” said Bruce Schwartz, M.D., President, American Psychiatric Association. “These plans could be catastrophic for many Americans with mental illness or substance use disorders if these disorders are excluded from coverage. Patients have complex medical needs and rely on strong, predictable insurance protection and care. We will continue to fight on behalf of our patients who are entitled, by the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, to comprehensive health coverage.”
“Children with complex medical needs require access to health insurance that covers essential health benefits and pre-existing conditions, and does not impose monetary caps on care,” said Elena Hung, President and Co-founder, Little Lobbyists. “The Affordable Care Act assures these families that any plan they purchase will have these protections, but the Administration’s short-term limited-duration insurance plans guarantee none of these protections and will ultimately leave many of those who purchase them without the care they need and facing financial ruin. This is the Administration’s health care plan, and Americans deserve and demand better. We will continue the fight against these dangerous ‘junk plans’ on appeal.”
“Short-term limited-duration insurance plans are not another way of promoting access to health care for Americans,” said Paul Gionfriddo, President and CEO, Mental Health America. “By sidestepping critical consumer protections, they are a way to confuse consumers and deny access to necessary mental health and substance use benefits. We hope that on appeal, it is clearly recognized that simply having health insurance is not the goal – people need access to care.”
“NAMI has spent decades fighting for parity—fair and equal coverage of mental health conditions. We have no intention of stopping until we end discriminatory coverage. This ruling is a step in the wrong direction. It lets junk plans compete with comprehensive health insurance, even though they don’t have to provide the same level of mental health coverage—or any mental health coverage at all. This undermines the very intent of mental health parity,” said Angela Kimball, acting CEO, National Alliance on Mental Illness. “We will join an appeal of this decision because the health of our nation includes its mental health. It is imperative that insurance plans provide essential mental health benefits for all Americans, plain and simple.”
“We continue to oppose the Trump administration’s short term limited duration insurance rule, which expanded the availability of junk insurance plans, and we stand with our allies in seeking a reversal of the rule from the appellate court,” said Debra L. Ness, President, National Partnership for Women & Families. “These skimpy, junk insurance plans masquerade as Affordable Care Act-compliant plans while discriminating against women and offering none of the protections such as maternal care, contraceptive care, or coverage for pre-existing conditions. The National Partnership is committed to eliminating these sham plans that threaten the health and economic security of America’s families.”
For more information:
- All resources and news related to the case are compiled here: www.stopjunkinsurance.com.
- American Cancer Society-Cancer Action Network: Short-Term Insurance Coverage is Inadequate, Confusing and Expensive for Patients.
- Center on Budget and Policy Priorities: Blocking Trump Rule on Short-Term Health Plans Would Benefit Consumers.
- The Commonwealth Fund: States Step Up to Protect Insurance Markets and Consumers from Short-Term Health Plans.
- Modern Healthcare: Commentary, Short-term, limited-duration health plans pose risks for patients, healthcare providers.
- Forbes: The Next Assault on Affordable Healthcare: Short-Term, Limited-Duration Health Plans.
- Consumer Reports: Short-Term Health Insurance Isn’t As Cheap As You Think.
- Georgetown University Health Policy Institute: “Consumers shopping online for health insurance, including those using search terms such as ‘Obamacare plans’ or “ACA enroll,’ will most often be directed to websites and brokers selling STLDI or other non-ACA compliant products.”
- A recent CBO report found that Association Health Plans (see below) and junk plans together will increase premiums in the individual market by “roughly $350 to $400 for single coverage and by $900 to $950 for family coverage.”
About the Association for Community Affiliated Plans
The Association for Community Affiliated Plans (ACAP) represents 66 Safety Net Health Plans, which provide health coverage to more than 21 million people in 29 states. Safety Net Health Plans serve their members through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Marketplace and other health programs. For more information, visit www.communityplans.net.
About AIDS United
AIDS United works to end the HIV/AIDS epidemic in the United States through strategic grantmaking, technical assistance and capacity building services, policy and advocacy. AIDS United’s Public Policy Council (PPC) of 53 HIV/AIDS Service organizations, national and regional coalitions is the largest and longest-running community-based HIV/AIDS domestic policy coalition in the country. AIDS United additionally represents more than 200 grantee and subgrantee AIDS Service Organizations serving people living with HIV throughout the United States. More information can be found at www.aidsunited.org.
About American Psychiatric Association
The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,500 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information please visit www.psychiatry.org.
About Little Lobbyists
Little Lobbyists is an organization working to protect and expand the rights of children with complex medical needs through advocacy, education, and outreach. The group was founded by and is led by families of children with complex medical needs and disabilities requiring specialized and ongoing health care. These families face significant challenges in caring for their children and experience first-hand the impact that federal and state laws and policies have on their lives. The mission of Little Lobbyists is to support, inform, and advocate for this growing community of families and their unique needs. For more information, please visit www.littlelobbyists.org and @LittleLobbyists on Twitter, Facebook and Instagram.
About Mental Health America
Mental Health America – founded in 1909 – is the nation’s leading community-based nonprofit dedicated to addressing the needs of those living with mental illness and to promoting the overall mental health of all Americans. Our work is driven by our commitment to promote mental health as a critical part of overall wellness, including prevention services for all, early identification and intervention for those at risk, integrated care, services, and supports for those who need it, with recovery as the goal.
About the National Partnership for Women & Families
National Partnership for Women & Families is a nonprofit, nonpartisan advocacy group dedicated to promoting fairness in the workplace, reproductive health and rights, access to quality, affordable health care, and policies that help all people meet the dual demands of work and family. More information is available at NationalPartnership.org.
About the National Alliance on Mental Illness
The National Alliance on Mental Illness (NAMI) is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. Learn more about www.nami.org | facebook.com/nami | twitter.com/namicommunicate | instagram.com/namicommunicate.
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