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People with pre-existing conditions could face tough times ahead

President Donald Trump and his administration are taking steps to lower premiums, increase choice and foster competit...

Posted: Mar 1, 2018 1:35 PM
Updated: Mar 1, 2018 1:35 PM

President Donald Trump and his administration are taking steps to lower premiums, increase choice and foster competition in the health insurance market. All of that sounds good -- until one realizes that the changes are coming largely at the expense of millions of Americans with pre-existing conditions.

The administration has issued two proposed rules in recent months that will allow more people to sign up for alternatives to Obamacare. But the actions are expected to mainly help younger and healthier consumers, while hurting those with spottier health histories.

That's because the proposed regulations, combined with Congress' elimination of the individual mandate next year, will whittle away at Obamacare's sweeping protections for those with pre-existing conditions. This will leave those who are or who have been sick at risk of paying higher premiums, losing their comprehensive coverage or being left without an insurer on the Affordable Care Act exchanges.

"The end result is that you will have two markets," said Sabrina Corlette, research professor at Georgetown University's Health Policy Institute. "One that's for young and healthy individuals who don't need a lot of health care, and another that will provide comprehensive coverage for people with pre-existing conditions, but will be much more expensive."

Obamacare revolutionized health insurance for people with pre-existing conditions. Under the health reform law, insurers could no longer deny coverage to consumers because of their medical history or base premiums on it. Also, carriers were required to cover 10 essential health benefits, including maternity care, mental health services and prescription drugs.

These provisions were among Obamacare's most popular reforms, but they were also one of the main reasons why coverage on the individual market became so pricey. That has made these protections a target.

Shortly after Congress abandoned its attempt to repeal and replace Obamacare in late September, Trump issued an executive order that he said would give millions of Americans more access to affordable coverage. The president's directive laid the foundations for the two proposed rules.

The first one, unveiled in early January, would make it easier for small businesses to band together based on their industry or location and buy coverage through so-called association health plans.

The proposal would allow association plans to be regulated in the same way as large employer plans. That would free them from having to adhere to all of Obamacare's rules, particularly the one requiring insurers to offer comprehensive coverage. So these plans would likely have lower premiums, but also provide fewer benefits -- which could leave sicker and older workers out in the cold. Also, the offerings could be less attractive to young women if they don't cover maternity benefits.

Related: Trump officials unveil rule that could chip away at Obamacare

The proposed regulation would also allow associations to base rates on gender and age, which could leave younger men paying less but older workers and women saddled with higher rates. Currently, the Affordable Care Act bans basing premiums on gender and limits the amount that can be based on age. However, plans would not be allowed to set premiums based on workers' health status.

If the proposed rule is finalized in coming weeks, premiums for Obamacare policies would rise 3.5% to an average of $15,000 a year, largely because healthier enrollees would opt for association plans, according to a new study by Avalere Health, a consulting firm. Those buying the new small business plans would pay $5,300, on average.

"The proposed rule would lead to millions of individuals and small businesses shifting into a new form of coverage, likely reducing their premiums, but leading to higher premiums in the markets they leave behind," said Chris Sloan, senior manager at Avalere.

The administration's second proposed regulation, which was released last week, will make it easier to obtain coverage through short-term health insurance plans by allowing insurers to sell policies that last just under a year. The proposal would reverse an Obama administration decision to limit the duration of short-term health plans to no more than 90 days in order to make them less attractive.

Short-term plans are allowed to exclude those with pre-existing conditions and can base rates on an applicant's medical history. They don't have to offer comprehensive coverage and they can impose annual or lifetime limits on benefits, meaning they may only pay out a set amount -- often $1 million or less -- leaving the policyholder on the hook for the rest. Also, they don't have to cap the amount consumers have to pay in deductibles and co-pays every year.

Related: Trump administration unveils alternative to Obamacare

Consumers today can find short-term plans that cost as little as 20% of the least expensive Obamacare plan, according to the Kaiser Family Foundation. Once short-term plans are available, healthy people may turn to them instead of Obamacare policies, pushing up the rates for those who remain on the exchanges.

Congress' elimination of the individual mandate could also hurt those with pre-existing conditions, particularly those who don't qualify for federal premium subsidies, health policy experts say. Without the mandate, which requires nearly all Americans to get coverage or pay a penalty, healthy people will have less incentive to enroll. So premiums for those left on the exchanges are likely to rise.

Even more concerning, experts are waiting to see whether insurers want to remain on the exchanges in 2019 if policyholders are older and sicker. For a while last year, it looked like tens of thousands of people could have had no choice of insurer in 2018 as carriers dropped out amid all the uncertainty in Washington D.C. However, state officials were able to convince insurers to cover all the so-called bare counties before open enrollment began in November.

Minnesota Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 25208

Reported Deaths: 1060
CountyConfirmedDeaths
Hennepin8514616
Ramsey3075128
Stearns203013
Nobles15445
Anoka142970
Dakota134957
Washington64532
Olmsted63410
Kandiyohi4971
Rice4622
Scott4362
Clay42728
Mower3452
Wright3202
Todd3190
Sherburne2462
Carver2182
Benton1783
Steele1600
Blue Earth1420
Martin1325
Freeborn1250
St. Louis11814
Pine890
Unassigned8810
Nicollet8810
Winona8015
Cottonwood760
Watonwan750
Carlton750
Crow Wing712
Otter Tail700
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Polk612
Lyon570
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Dodge530
Chippewa511
Morrison470
Meeker450
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Becker400
Murray390
Jackson390
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Rock220
Swift190
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Norman130
Marshall120
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Wilkin113
Wadena100
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Pope90
Aitkin80
Mahnomen61
Yellow Medicine60
Big Stone60
Lincoln50
Redwood50
Renville50
Red Lake40
Grant40
Lac qui Parle30
Clearwater30
Traverse30
Houston20
Hubbard20
Roseau20
Lake10
Kittson10
Stevens10

Iowa Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 19669

Reported Deaths: 555
CountyConfirmedDeaths
Polk4236133
Woodbury276136
Black Hawk174745
Linn95379
Dallas91623
Marshall89616
Buena Vista8100
Johnson6149
Wapello59712
Muscatine55741
Crawford5282
Tama40327
Scott36110
Dubuque34619
Louisa34511
Sioux2830
Pottawattamie2698
Jasper26017
Washington1898
Wright1780
Warren1350
Plymouth1332
Allamakee1204
Story1161
Mahaska9510
Poweshiek908
Henry711
Bremer696
Des Moines651
Boone650
Clinton641
Taylor560
Clarke560
Guthrie513
Cedar481
Benton431
Hamilton430
Webster421
Monroe385
Shelby370
Jones360
Clayton343
Osceola340
Buchanan330
Iowa330
Marion320
Cherokee310
Jefferson300
Cerro Gordo291
Madison292
Lee270
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Monona250
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Lyon240
Davis230
Harrison230
Dickinson210
Sac200
Grundy200
Mills190
Floyd191
Humboldt181
Clay170
Delaware171
Hardin170
Butler171
Lucas170
Emmet160
Hancock160
Appanoose143
Ida140
Page140
Franklin140
Keokuk140
Pocahontas130
Greene130
Howard120
Cass120
Audubon121
Jackson120
Carroll110
Winnebago110
Chickasaw100
Kossuth100
Adair90
Van Buren90
Union90
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Fremont40
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Mitchell40
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