NORD supports the Affordable Care Act (ACA) and its requirements that health insurers offer comprehensive plans with strong patient protections and opposes efforts to expand access to short-term, limited-duration health plans.
The ACA established a set of critical protections that benefit individuals living with rare diseases, including prohibiting insurers from denying an individual health coverage because of a pre-existing condition, charging an individual more because of their health status, or excluding certain benefits in order to discourage those with complex health conditions from enrolling in their plans. The ACA also established health care marketplaces, or exchanges, to help facilitate access to affordable health insurance for all Americans and establish a minimum standard of quality for all plans.
Short-term, limited-duration health plans
Rare disease patients need affordable, comprehensive health insurance benefits to adequately treat their conditions. Short-term, limited-duration health plans are not required to meet the quality standards outlined in the ACA, and in many cases, are able to discriminate against patients with pre-existing conditions or not provide coverage for essential health care needs. Additionally, many short-term, limited-duration plans have been found to use deceptive marketing practices, causing some individuals to enroll in these plans believing that they will receive the same benefits as a comprehensive plan.1 It is only after an unexpected health issue, such as a rare disease diagnosis, that those individuals discover that they do not have sufficient health care coverage and cannot access the care they need.
Additionally, the presence of short-term, limited-duration health plans in the marketplace can increase costs for rare disease patients. In order for health care costs for people with complex health conditions to remain affordable and sustainable, there must be significantly more individuals without complex health conditions participating in the same health care system. Since healthier individuals are more likely to choose to participate in plans that offer cheaper but less comprehensive coverage, the increase in the use of short-term, limited-duration health plans results in people with fewer routine health care needs segmenting themselves into a separate risk pool. Unfortunately, this leaves those with more complex health conditions bearing the brunt of higher health insurance costs.
1. Corlette, S., Lucia, K., Palanker, D., & Hoppe, O. (2019, January 31). The Marketing of Short-Term Health Plans. RWJF. https://www.rwjf.org/en/library/research/2019/01/the-marketing-of-short-term-health-plans.html
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