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Short-Term Health Plans, California Says: “No”

Short-Term Health Plans, California Says: “No”

Short-Term Health Plans, California Says: “No”, Repeal / Replace / Repair, Ken Ruotolo, Chief Operating Officer

Under the Affordable Care Act (ACA), insurers are permitted to sell short-term health plans that are not required to meet the higher standards imposed on traditional plans. Short-term plans are meant to act as a bridge for individuals transitioning from one form of comprehensive coverage to another and as such their term is limited to three months.

On August 1, 2018, the Trump administration issued a final rule redefining the permissible term of short-term plans to 364 days and adding that such plans could be renewed twice, effectively allowing a subscriber to stay covered under a short-term plan for three years. The goal, according to the Trump administration, was to provide more options for individuals not wanting to purchase the more comprehensive coverage required of traditional ACA plans, which are also more expensive than short-term plans.

In California, lawmakers and insurance carriers became concerned that healthy individuals, who would be willing to forego higher benefits in exchange for lower cost, would terminate coverage in traditional plans and enroll in short-term plans; this could have the effect of destabilizing traditional insurance pools. In addition, lawmakers, in particular, were concerned that consumers might enroll in short-term plans not understanding that they do not provide the kind of coverage or financial protection embedded in traditional ACA plans.

To address these concerns, State Senator Ed Hernandez wrote Senate Bill 910 that bans short-term plans outright in California. Since most insurance is regulated at the state level, California’s action on this matter could not be overridden by the federal government. Governor Jerry Brown agreed and signed SB 910 into law in late September. Effective January 1, 2019, short-term health plans cannot be sold in California.

Questions?
Contact our small group experts at 800.696.4543 or info@claremontcompanies.com.


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