Families USA, Mental Health America, the National Alliance on Mental Illness, and the National Council for Behavioral Health are four nonprofit, nonpartisan organizations that represent health care consumers, including those with mental health and substance use disorders. We have joined together to bring attention to a heath care policy put forth by the Trump administration that expands short-term health insurance plans.
Earlier this week, Maryland and Virginia insurers filed proposed individual market premiums for 2019. Over the coming weeks and months, insurers in the other 48 states and DC will announce proposed premiums. In Maryland and Virginia, many insurers are asking for incredibly large premium increases. In Maryland, average requested rate increases are 30 percent over 2018. In Virginia, proposed premiums are rising more than 15 percent.
Under the guise of creating low-cost health options, the Trump administration has two new regulations that will have dire consequences for two groups:
As the largest single source of health insurance and coverage for behavioral health services in the country, Medicaid plays a pivotal role in addressing substance use disorder (SUD). Medicaid covers nearly 4 in 10 non-elderly adults in the country with opioid addiction. But this coverage could go further: at least 17 percent of opioid addicts are uninsured, a rate nearly 50 percent higher than the general population.
By weakening the standards around what benefits health plans must cover and other changes, the latest policy from the Trump Administration will threaten the quality and affordability of health coverage.
Trump Administration 'Public Charge' Rule Threatens Health Care for Immigrant Families, Including U.S. Citizen Children
The impact of a proposed Trump administration rule extends well beyond the directly targeted individuals and families whose health will be at risk. A community’s overall health depends on the health of all of its members. The impact of this proposed rule will spill over to others in many ways. Without insurance, families may delay care or forego it altogether. This means there will be more children in school, and adults in the workplace, without needed preventive services and untreated illnesses. More people delaying care until the last possible moment will strain emergency resources. Hospitals’ and clinics’ uncompensated care burdens will increase.
Funding CSR Payments in the Health Insurance Stabilization Package Could Harm Low- and Middle-Income Consumers
Families USA strongly supports bipartisan efforts to give consumers affordable health insurance in the individual market. A successful stabilization bill would enhance affordability and access by raising advance premium tax credits (APTCs), funding reinsurance, financing outreach and enrollment assistance, and stopping proposed regulations that would let short-term plans and association health plans (AHPs) substantially undermine the individual market.
CMS has approved work requirements (sometimes spun as “community engagement” requirements) in three states: Arkansas, Kentucky, and Indiana. Eight additional states have similar requests pending, and CMS appears likely to approve those requests, as well. Litigation challenging the authority of the executive branch to approve work requirements—rules that are contained nowhere in Medicaid law—have also begun.
On March 5, 2018, CMS approved Arkansas’ request to add a work requirement to its Medicaid program. Equally important, it did not approve the state’s request to roll back Medicaid eligibility to a partial Medicaid expansion. Both tell us a lot about what’s behind CMS’s approach to Medicaid waivers, and what states can expect to have, and not have, approved. View factsheet here.