Trump’s ‘Terrific’ Health Plans = Junk
Terry H. Schwadron
Aug. 5, 2018
As a candidate — and even as President — Donald Trump promised to eliminate Obamacare and replace it with “something terrific” that was much better.
Apparently, we now see it: Low-priced premium programs that actually do little to provide practical health insurance. These are built on what insurance companies had been offering as stopgap, temporary measures for people between health plans, but now can be extended for a year or more.
Generally speaking, you can’t count on these programs to offer maternity care, wellness and preventive care, deal with pre-existing illnesses, cover prescriptions or provide for mental health. Even for hospital care, there are hard limits, and there are high deductibles before coverage.
But they do have lower cost per person per month than Obamacare policies. So, Trump has fulfilled his campaign promise, I guess.
It’s just not “terrific.”
In an interesting analysis, Catherine Rampell of The Washington Post has looked into the fine print of the health plans authorized this week by the White House, and found them to be, well, inadequate for most health problems.
“We have finally learned his grand plan for reducing Americans’ health-care costs. It is: Don’t get sick. Ever,” she says.
At the same time, Politico.com has looked into Trump’s policies concerning prescription drug prices.In July, for example, Trump tweeted to pressure Pfizer into suspending price raises for several drugs, and Pfizer responded by suspending some of its planned price hikes, as did a few other companies.
But overall, Politico concludes from having surveyed drug prices and Big Pharma revenue statements, “The gestures turned out to be largely symbolic — efforts to beat Trump at his own game by giving him headlines he wants without making substantive changes in how they do business.”
On Wednesday, the administration announced new rules expanding the availability of what have been called junk insurance plans, allowing the short-term insurance to be renewed up to 36 months at low premiums by skipping most of what we expect from health insurance. “Unless states step in, these not-so-short-term ‘short-term’ plans are not subject to any of the protections required by the Affordable Care Act,” Rampell noted.
As a result of these low-cost programs, however, actual health insurance for older, sicker Americans, or patience with long-term health conditions like cancer, heart disease, diabetes, asthma, skin problems, bad backs will cost a whole lot more, because the young, employed, largely male population that wants the low-cost premiums will not be sharing the cost of actual health insurance.
In the recent past, some of these low-cost plans have dropped consumers as soon as they got an expensive diagnosis, sticking them with hundreds of thousands of dollars in unexpected medical bills. A Kaiser Family Foundation review of short-term plans offered around the country found that most did not cover prescription drugs, and none covered maternity care. Preventive and mental-health care are also frequently excluded.
Health care listed as “covered” might have limits on payments, like a cap on benefits or no coverage for a hospital stay that begins on a weekend.
“The tiny print can be endless. And as former head of the Centers for Medicare and Medicaid Services Andy Slavitt points out, consumers will never, ever be as good at reading the fine print as insurance companies will be at writing it.
Because these plans cover so little, cherry-pick their enrollees and pay out so infrequently, premiums tend to be dirt-cheap. The Trump administration estimates that people who purchase short-term plans will pay about half the average unsubsidized premium on the Obamacare exchanges.”
The combination of expanding short-term plans and repealing the individual mandate will increase Obamacare premiums by an average of 18% in the 42 states (and the District) that don’t already prohibit or limit short-term plans, according to an Urban Institute study, Rampell reported.
Those who do not qualify for Obamacare subsidies will shoulder much larger costs, and will increase costs for the federal government to cover people who do qualify.
“Trump’s real plan for American consumers: Stay healthy, or drop dead,” said Rampell.
Trump has properly made a big deal of constantly rising prescription drug prices. But his efforts so far seem less than effective, according to the Politico review. “Of the few companies that actually cut prices, for instance, most targeted old products that no longer produce much revenue — such as Merck’s 60% discount to a hepatitis C medicine that had no U.S. revenues in the first quarter. Other (companies) volunteered to halt price increases for six months — in some cases, just weeks after announcing what is normally their last price hike for the year,” said Politico.
Politico said the industry’s “deft response to Trump’s tweet shaming has also become a test of whether his administration is serious about following up with an aggressive crackdown on the companies or will simply declare victory based on token measures and move on.”
When you hear that there is a “terrific” alternative to Obamacare, take a look at the fine print.