Today the Department of Health and Human Services (HHS) issued its final rule for Medicare Part D which does not include the full range of proposed changes to drugs in the ‘six protected classes’ of cancer, epilepsy, HIV/AIDS, mental illness and organ transplants.
Senate Rejects Resolution to Halt Short-Term Insurance Changes and Preserve Patient Protections
Washington, D.C.—Today the U.S. Senate rejected a resolution under the Congressional Review Act that would have prevented the extension and expansion of short-term limited duration health insurance plans (STLD) as allowed under a new rule from the Departments of Health and Human Services (HHS), Labor and Treasury. The rule allows insurers to issue – for up to 36 months – so-called short-term health insurance plans. Insurers can deny or charge people more for these plans based on their health status, are not required to cover essential health services, like prescription drugs, and can charge older people more than three times what they charge a younger person for the same coverage. Previously these policies were intended as “bridge” coverage to provide temporary insurance for no more than three months.
Although the resolution failed to pass the Senate, a lawsuit has also been filed in U.S. District court to stop the rule. The American Cancer Society Cancer Action Network (ACS CAN), along with several other patient advocacy organizations, has filed an amicus brief in support of the court challenge.
A statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN) follows:
“Today the Senate missed an opportunity to protect health care coverage for cancer patients, survivors and all those with serious medical conditions.
“The final short-term health plan rule could divide the insurance market and weaken critical patient protections. By attracting younger, healthier individuals to these bare bones plans, the rule will likely upend risk pools that keep costs down for older and sicker individuals. By splitting the market, people who need comprehensive health insurance will likely find it far more expensive and potentially out of reach.
“These short-term plans can set limits on how much they’ll pay for certain services or refuse to cover some services —like innovative cancer treatments or prescription drugs—altogether. Insurers can charge people more for coverage based on their pre-existing conditions or deny them coverage outright.
“While these plans will likely have lower monthly premiums they will also leave enrollees with potentially inadequate health coverage if they are diagnosed with an unexpected illness like cancer and could lead to astronomical out-of-pocket costs to pay for care that is not covered.
“Earlier this week, several patient groups signed on in support of a lawsuit to stop this rule, which effectively allows STLD plans to serve as replacements for comprehensive coverage in violation of current law.
“Although Senators failed to keep their promise to protect people with pre-existing conditions today, we are hopeful the court will issue an injunction and uphold current limits on these inadequate plans.”