On Thursday, October 12, President Donald Trump issued an executive order instructing federal agencies to consider expanding access to association health plans (AHPs) and short-term, limited-duration insurance (STLDI), which could negatively impact people with chronic conditions like cystic fibrosis who get their coverage through the individual or small group markets.
The executive order will have no immediate impact on health insurance markets. Federal agencies will now consider the president's executive order and determine what steps can be taken to change the types of plans that are offered. In response to the order, agencies will begin a rulemaking process that should involve opportunities for public comment in the coming months.
Under President Trump's executive order, AHPs and STLDIs may not be required to comply with pre-existing condition protections or essential health benefit standards, allowing plans to deny coverage for the care that people with chronic conditions like CF need.
The potential changes described by the executive order could also encourage younger, healthier people to enroll in these lower quality, cheaper plans. This could cause the pool of enrollees in the existing health insurance marketplace to be sicker and older, driving up premiums for people with CF and other chronic diseases who rely on these plans and the protections they provide to get the care they need to stay healthy.
Later that same day, the Trump administration announced plans to stop cost-sharing reduction (CSR) payments to health insurance companies. CSR subsidies are paid to insurance companies to help low-income individuals afford their out-of-pocket costs.
At this time, the impact of the president's decision on CSR subsidies remains to be seen, and likely will vary by state.
Cost-sharing reduction payments are a critical tool for the health insurance marketplace, keeping care affordable for many people with CF and other chronic diseases. Without CSR payments from the federal government, insurance companies are still responsible for helping cover out-of-pocket costs for low-income people, and some may pull out of the market without this government support.
The Cystic Fibrosis Foundation is monitoring these developments closely and will continue to advocate on behalf of people with cystic fibrosis as conversations around health care reform continue. We will inform the CF community as more information becomes available.