Short-Term Health Plans Must Offer Full Benefits, Vermont Says

By: - October 17, 2018 12:00 am

A doctor, left, his patient, and a social worker in Montpelier, Vermont, earlier this year. The state is requiring that short-term health plans offer services mandated by the Affordable Care Act. Wilson Ring/The Associated Press

Vermont is taking steps to ensure that short-term health insurance plans, which recently received a boost from the Trump administration, provide benefits guaranteed under the Affordable Care Act.

The Vermont Department of Financial Regulation has indicated that it will soon file new rules that would require short-term health insurance plans to cover the 10 “essential” benefits mandated by the ACA, which include coverage for maternity and newborn care, prescription drugs, mental health and substance abuse treatment, and hospitalization.

Earlier this year, the Trump administration increased the allowable duration of short-term plans from three months to a year. Under federal law, such plans do not have to include the services required by the ACA, making them cheaper than traditional plans. Short-term policies are intended as a bridge for people who are between jobs or who have otherwise lost their coverage temporarily.

But Michael Pieciak, commissioner of Vermont’s Department of Financial Regulation, told VTDigger, a Vermont news website, that in the case of short-term plans, affordability often translates into insufficient health care coverage.

“They’re less expensive for a reason,” Pieciak said. “It’s because the coverage isn’t nearly as robust.”

Earlier this year, the state acted to thwart another effort by President Trump to undermine the ACA. The administration had made it easier for businesses and other organizations to band together to offer non-ACA-compliant health insurance policies to employees. In response, Vermont issued an emergency rule requiring that so-called association health plans also offer the 10 essential health benefits mandated by the ACA.

Vermont joins several other states in pushing back against the Trump administration’s rules on short-term policies. Illinois, Maryland and Oregon also have limited the duration of short-term policies to less than a year. And Massachusetts, New Jersey and New York have virtually outlawed such plans.

Eleven states and Washington, D.C., have gone to court to challenge the administration’s new rules on association health plans.

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Michael Ollove

Michael Ollove covers health care for Stateline. Ollove worked for many years at The Baltimore Sun, as an enterprise reporter and an editor.