- Patients insured under short-term health plans who later develop cancer could face out-of-pocket costs of more than $100,000, a study from the American Cancer Society's Cancer Action Network found.
- The report examined short-term plans with durations from three months to a year to determine what bills a hypothetical insured woman who later develops breast cancer could expect to pay.
- Short-term insurance plans are facing scrutiny from Congress, patient advocates and safety net insurers, who argue consumers are often unaware the plans offer only bare-bones coverage.
The Trump Administration has expanded market access to short-term health insurance plans, which have low premiums but aren't required to offer comprehensive coverage. These types of plans are allowed to deny people coverage for pre-existing medical conditions but this study looked at what the plans would pay out if an insured person later develops a serious medical condition such as cancer.
Because the short-term plans can impose lifetime and annual coverage limits and aren't required to offer essential health benefits under the Affordable Care Act, the coverage is much less robust than available under ACA-compliant plans.
And what the study found wasn't reassuring.
A three-month short-term plan would cover a little less than $60,000 in cancer services, leaving the insured responsible for more than $111,000 in treatment costs and nearly more than $363 in premiums. And, while the insured's cost-sharing under a longer duration 12-month plan was less daunting, that plan was still estimated to leave the patient with more than $40,000 in treatment costs and more than $31,000 in premium payments.
American Cancer Society advocates that having adequate and affordable health insurance coverage is a key factor in whether patients survive cancer. Uninsured Americans are less likely to get screened for cancer and are more likely to have their cancer diagnosed at an advanced stage when survival is less likely and care costs more.
The Obama administration limited short-term plans to no more than three months in duration (with no ability to extend coverage) and required such plans to display a prominent disclaimer they weren't compliant with the ACA's minimum essential coverage requirements. But the Trump administration 2018 final rule expanded access to short-term plans and allowed them to be extended for up to 36 months.
The plans, which opponents deride as "junk" insurance, are the subject of House Committee on Energy and Commerce probe. The investigation will look into what the plans cover, their business practices, advertising strategies and their popularity with consumers. Meanwhile, a coalition of patient advocates and safety net health insurers are suing the Trump administration over the rule, claiming, among other things, the plans are being marketed as primary coverage and are destabilizing insurance markets.