Industry groups: New CMS policy puts Americans with pre-existing conditions at risk

More than 25 patient and consumer groups have spoken out against a new guidance issued by CMS on Tuesday that allows states to skirt patient protections mandated under the Affordable Care Act.

The guidance significantly loosens regulations with respect to what plans can be offered under state innovation waivers. The policy will allow states to sell short-term limited-duration plans, which do not follow ACA requirements and often do not cover those with pre-existing conditions.

In backlash to the guidance, industry groups, including the American Heart Association, American Diabetes Association, National Health Council and many more, issued a statement.

“The guidance issued by the Administration gives states free reign to undermine critical protections for millions of Americans living with pre-existing conditions. Issued under the guise of ‘state flexibility,’ the guidance allows states to approve the sale of cheap, inadequate health insurance plans that can eliminate coverage of pre-existing conditions, charge premiums based on health status, or reject patients altogether,” the letter reads.

States will also be able to offer subsidies for less comprehensive health plans, according to the guidance, which the groups also opposed.

More than 100 million Americans qualify as having a pre-existing condition, according to a recent analysis.

CMS Administrator Seema Verma defended the guidance Wednesday, stating in a tweet, “Nothing about the new flexibilities issued in the State Relief & Empowerment Waivers’ guidance would allow states to erode protections for pre-existing conditions.”

However, the short-term, limited-duration plans, which were recently expanded by the Trump administration, do not have to cover pre-existing conditions.

Some Democratic lawmakers also spoke out against the new changes.

“The administration’s newest move lets states offer junk plans that threaten quality & affordable care,” Sen. Ron Wyden (D-OR) said in tweet Tuesday.