Internists Concerned New Insurance Rule Will Increase Premiums, Destabilize Insurance Market

Statement attributable to:
Jack Ende, MD, MACP
President, American College of Physicians

Washington, DC (February 22, 2018) — The American College of Physicians (ACP) is concerned about the government’s proposed rule to allow Americans to purchase extended, short-term, limited-duration health insurance plans.  ACP believes that the proposal will harm patients by destabilizing the Affordable Care Act’s (ACA) individual insurance market and undermining essential patient protections, resulting in higher premiums and increased medical costs for those most in need of care.

Short-term, limited duration health insurance plans are not subject to the ACA requirements that health plans cover essential benefits, like chemotherapy for cancer; that health plans not charge more to patients with pre-existing conditions; and that health plans not impose lifetime limits on coverage.  Under existing regulations, short-term, limited duration plans are available only as a three-month temporary insurance for people who have a break in coverage.  They are not intended to replace comprehensive health insurance for an extended period of time.  Allowing the sale of such limited plans for a year or even longer, as proposed in the rule, would leave patients with chronic or acute disease at risk for losing access to key health services they rely on, including laboratory tests, hospital stays, and prescription medications.  While at first glance, short-term, limited duration plans may appear to be a good value, in reality, they don’t provide much coverage at all. 

The proposed rule also presents a great risk to the insurance marketplace, as healthy people will likely opt to buy short-term plans rather than comprehensive marketplace-based coverage.  The individual market could become saturated with sick patients and particularly hurt those with pre-existing conditions who do not qualify for premium and cost-sharing subsidies.  Moreover, with the ACA’s individual mandate penalty all but eliminated, there are now fewer barriers to prevent healthy people from leaving the marketplace, leading to a limited selection for those that remain—resulting in unaffordable premium increases for enrollees who don't meet the requirements for subsidized coverage.  The federal government would also be obligated to pay hundreds of millions more annually in premium subsidies to offset the higher premiums for those eligible for subsidized coverage.

ACP calls on Congress and the Administration to focus on policies that promote accessible and affordable health care coverage for all Americans as opposed to allowing the purchase of extended, short-term insurance plans that offer a temporary and costly option that will do great harm to patients most in need of health insurance coverage.


About the American College of Physicians

The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.

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