AMA opposes non-ACA-compliant insurance plans without protections for preexisting conditions

Despite claims otherwise from President Donald Trump, the Affordable Care Act remains the law of the land—though federal actions have increased instability in the ACA’s marketplaces. Following last year’s repeal of the individual mandate, insurers are now offering short-term, non-ACA-compliant policies, which could leave a sicker, older population shopping on ACA marketplaces.

The American Medical Association, in a June 12 release, announced opposition to plans that do not include protections guaranteed by the ACA—such as coverage of essential health benefits, protections for those with preexisting conditions and the elimination of annual or lifetime limits.

“The AMA knows that insurers are more likely to participate in marketplaces with large and healthy risk pools,” said AMA President David O. Barbe, MD. “We need to take steps to ensure that healthy individuals stay enrolled in coverage offered in the ACA marketplaces and are not siphoned off into coverage that does not guarantee critical patient protections, leaving behind a sicker population facing higher premiums in ACA-compliant coverage.

“At some point, people who are currently healthy are going to have to seek medical care, and we need to make sure that they avoid sham coverage that does not provide them with the coverage and financial protection they counted on at the time of enrollment.” 

The AMA joins many major healthcare groups in criticizing such relaxed standards for insurance plans. Meanwhile, insurers are forecasting major premium hikes in 2019, with some estimates topping 30 percent for ACA plans—this after an average increase of 34 percent this year for a silver-level plan on the ACA exchange.