Wow, plans that spend up to 50% of their premium on company profits and administration overhead.
I wonder how many people remember that Medicare has an overhead percentage of.... 1.8%
Medicare for all is within reach, we just need to demand our politicians give it to us. The program is already set up. Yes, we will all pay something out of our paychecks... but that will be a lot less than the premiums we pay now, and for healthcare that's a million times better -- ask any senior citizen how good it is.
6
Brokers also made more in commissions 10 years ago when they sold a sub-prime mortgage versus prime. Hmm...
1
The state of US healthcare was a major reason for us to retire in Mexico. The government-run system called IMSS covers everything 100% and costs sbout US$400 a year each. But it can be slow, so we each have an almost-worldwide policy that covers everything ($1000 deductible) for about $2000 a year each.
The "almost" is the exclusion of one country that would greatly increase the premium. When we visit that country, we buy expensive daily traveler's health insurance.
Guess which country that is? Clue: it's the one where healthcare is a privilege instead of a right; a business instead of a critical service.
(Also: see the article on senior citizen bankruptcies in this very same issue of the Times.)
11
" In Atlanta, for example, the least expensive Obamacare plan for a 40-year-old single man was $371 a month. "
In Australia , for example, the most expensive Private Health Plan for my 5 Member Family including one Adult Smoker and my Wife who has a chronic Heart condition is $290 a month "
(No Co- Pays or deductibles)
Yet somehow , I manage to afford such a high cost for my Family...
(I am only joking...it is nothing and costs the same as the amount I pay for 8 pkts of cigarettes which I smoke every week.)
2
" Plans that follow the Obamacare rules are required to spend at least 80 percent of all premium dollars on medical care, keeping only 20 percent for overhead and profits. There are no such rules for short-term plans."
Keeping ONLY 20% for overhead and profits?!
I think I have found the reason why American Health Care coverage costs are so expensive...20% is a HUGE amount for an Insurance Policy/Health Care Insurance Company, especially when you consider the premiums are matched to the inordinately expensive costs of American Health Care!
( yet negotiated down by Insurers to hospitals, Doctors , Drug companies etc and representing additional cream off the cake for even greater profits NOT passed on to the Policy Holder , whose premiums, copays and deductibles are based on the unnegotiated price of these services/items)
Which is the reason why no other Health Care System in the World operates for profit but instead operate on the basis of meeting all the needs of all their people , for the absolute best outcome possible...
Except in America which does not value their needs, or even whether they have coverage ...above the profits to be made from what most money can be taken from them.
4
Capitalism was a choice, and the distorted and unbalanced form of it practiced in this nation a series of choices over the decades, increasingly imposed upon the masses by those who have benefitted the most and will do anything to protect their profits, income and wealth explosion.
The system can not be sustained as is. The concentrations of wealth are simply in the hands of too few.
I actually think a more compassionate and humane form of Capitalism could work, but those in power are utterly opposed to the changes it would require. They simply can not comprehend, nor do they wish to attempt to, the horrid circumstances of surviving on half the monumental wealth they now hold.
Until power and control is wrested from this small group and the politicians they own, nothing will change. Absolutely nothing.
14
These types of plans seem reasonable for a person like myself since the exclusions I do not need, however because I live in a "blue" state and paying over $1,600 hundred dollars a month for coverage, undoubtingly which is paying for others, these plans are not being offered in the state I reside....
1
After the tax cut scam on the people, they will really scam the people with cheap and useless health insurance policies, making more money than ever before for the corporations. How nice to make a note, the policies do not have ACA standards, wonder why not?
Peoples lives even young children are involved. People will pay and just when the contract expires an illness could pop up and they are not covered for it after paying premiums for one year or longer, nothing.
The government has become the enemy of the people.
6
The simple fact is that health care is not like ANY other good or service. I won't go into all the reasons but just consider one; it is the ONLY commodity where the entity paying for it has no say in the decision to purchase it.
Trying to apply free market principles to health care just doesn't work.
I could continue to discuss all the implications but the comments section only allows 1500 characters, not 1500 pages :).
6
As someone who has worked in the insurance industry (life, disability, long term care) for over 30 years, let me also note that in a state that does not have strong relations, when your 30 to 90 day policy is up, the new policy you get is NOT a continuation of the prior policy, so an undiagnosed cancer (for example) that began with vague left flank pain 6 months ago, will not be covered when the cancer is diagnosed in the time period of the new policy. These short term policies were never meant as more than bridges, so to cover a young person before full time benefits kicked in etc. That Republicans have lets this state of affairs continue is a shame.
13
@Terry McKenna That's huge. Hadn't heard that. Absolutely frightening. They can cut you off with any chronic condition after a few months?
1
A band aid would be better, and more honest.
5
As you'd expect from Trump, these "short-term" policies are a scam. They're worse than useless, as they let their buyers pay a substantial monthly premium on top of any health care expenses they pay out of pocket. That premium buys them no coverage if they get a serious injury or illness, and the insurance company will cancel their policy at the next renewal because of what is now a pre-existing condition. You might as well be making a monthly gift to the insurance company.
One reason the insurance industry allowed the modest reforms of the ACA was that pre-ACA underwriting created a situation in which insurers were obligated to exclude increasing numbers of people. That's an inherent problem with a capitalist approach to health care, where the paramount obligation to shareholders requires insurers to treat individual insurance policies as assets in an investment portfolio.
That means accepting only the healthiest applicants who can be counted on to pay continually escalating premiums every month without incurring "medical loss" (i.e., requiring health care), and rejecting everyone else. I suspect even insurance company CEOs considered that an untenable situation. The ACA's mandate and subsidies were the only solution to that conflict that would not destroy the medical-industrial complex.
Trump's "solution" does nothing to provide health care to those who need it, or to fix the flaws in the ACA. It's merely a return to the untenable situation before the ACA.
14
Choose your short-term healthcare company very carefully. When it comes to actually paying out for a covered item, I experienced extreme payment delaying tactics and an inability to speak with any customer service agent in a reasonable amount of time, and lack of response to emails or written letters to question or complain with a particular company, Agile Health administered by TPA.com, though they ultimately paid the claim after I complained to the state insurance board.
19
For those who support Medicare for All, do you realize that when you're 65 and about to receive the benefit (truly an entitlement because you've paid for it throughout your working life), you'll be paying approximately 10% tax - in addition to the Medicare supplemental plan costs - in perpetuity?
3
@Robin Yes Medicare is expensive, no doubt. But it is the only insurance available for 65 and older, private insurers can only keep their premiums lower because they exclude high-risk elderly people.
What else is there? Why can't we have decent health insurance?
We can't have good health insurance for the young and the old because the wealthiest nation in the world had a choice to pay trillions of $$ for a military warfighting budget or domestic services like food and shelter, education, healthcare and infrastructure including public transportation.
The nation voted for the huge military budget, and yes, that is why we have to pay high premiums for a health care millions of citizens can't afford because the taxes they do pay are not enough for social services when the health care eats up close to 20% of GDP.
That is why young people have to pay for Medicare while unable to pay for policies including maternity-care and prescription drugs.
The nation chose to pay for guns and tanks an airplane carriers and missiles. The money is there only not for the people's needs.
After the election, we will know which country the nation invades first, NK, Iran or Russia, there has to be a use for all the military hardware.
14
@R. Littlejohn
Exactly right. We have limited resources. How we decide to spend them - on guns or butter - will hopefully receive a fuller and fairer hearing in the next few years.
@R. Littlejohn
You are so on point! Thank you.
Thanks for a very informative article. Insurance companies are notorious for the fine print. Will the Trump administration require these plans to clearly and upfront (not buried in footnotes) state what they will NOT cover? Also, what happens at renewal time? If the policyholder has been diagnosed with something or filed serious injury claims that will require additional surgery or therapy during the initial term, I'm guessing they won't get renewed.
10
@abigail49 ACA provided some consumer protection, it was a step in the right direction. The short time policies will properly have all that was wrong before ACA and even more. The only way to make a profit is to provide less service for more $$. Being unregulated it will be a government approved scam on the voters, so they will start scamming the people after the election. That is what con-men and con-women do.
The Trump Administration has been saying they would lower healthcare costs throughout their entire presidency, and now they finally have, kind of. This article highlights many of the downfalls of these new short term healthcare plans, one being lack of coverage. These plans have many areas where they lack coverage, but for some people that is not an issue.
Under Obamacare each person was required by law to have health insurance. If you considered yourself healthy enough to live without coverage and did not purchase a plan, you could potentially face fines. This took away the freedom of individuals to choose if they wanted to purchase healthcare or not.
These new short term plans are a great solution to this dilemma. I would guess that the large majority of people who do not have health insurance would say that cost is the main issue here. Over the last few years there were a lot of young, healthy individuals paying hundreds of dollars a month for insurance that they did not want or need. These new plans give them an option to remain insured, and not spend a significant amount of money while doing so. I do agree that these new plans are not ideal for most people. A considerable amount of US citizens will need more coverage than these plans provide. But for those who only need insurance to avoid being fined and to cover the minimum, these new short term plans are ideal.
1
@KJ
The problem is that these plans don't cover sports injuries or injuries that occur when one has been drinking. They usually have high deductibles like $10,000 and they also don't cover joint replacement. Basically they are only in case of catastrophic illness like cancer and after the first year of treatment it ill be bye-bye insurance. So plan on saving money up front but paying thousands if you break a leg or arm, have an accident while riding your bike, skiing, etc. And if you get cancer that requires longer than one year of treatment you will also be paying for every expense over $250,000.
15
@KJ Freedom to not purchase healthcare is total nonsense. As long as the Emergency Medical and Treatment Labor Act says hospitals cannot deny uninsured patients, everyone should HAVE to buy health care if they can afford it, or apply for Medicaid. The law essentially makes health care a right, not a privilege.
I should think any true libertarian would agree that an individual should be responsible for their own hospital bill and not get free treatment at your or my expense, no?
9
@jmendi - I agree that everyone should have to pay for the medical care they receive. The problem - post ACA passage - is that too many people are now subsidized by those of us who pay taxes, and, especially, by those (my husband and I are in this category) who earn over 63K/year (in Colorado) and buy their own insurance.
I'm 59 y.o. and for the first time in my life I am uninsured because I could not pay $800/month for what amounts to a catastrophic plan since it would have meant selling our home. My husband is older, so we gambled and chose to insure him.
I know too many people my age who qualify for free health care. All of them chose careers (massage therapist, yoga teacher, fiddle player, artist) that gave them lots of free time, a low-stress job, along with an income that is easy to alter.
There is no means-testing or requirement that someone w.o. a disability work full-time nor is there any penalty for those with self-induced health problems brought on by lack of exercise, smoking or poor eating habits.
I don't favor Medicare for All because, once I reach 65, I'll be paying in perpetuity an additional 10% tax so that "All" can get what I already paid for.
Short term health plans are not required to provide essential health benefits like mental health, substance abuse treatment and drug coverage, and claim they are will become exempt from all state insurance laws.
It’s clear that our health-insurance system is broken when health insurance money is siphoned into the advertising budgets of private-profit insurance companies and the army of corporate bureaucrats working to deny claims. Insurance CEOs have collectively earned $9.8 billion since the Affordable Care Act was passed in 2010. Nearly a third of all of our health-care dollars go to something other than health care.
The deceptive appeal of Trump's stunningly inadequate plan is very low premiums because it covers only about half of health-care costs. Plans like this will work great if you never get sick or have an accident.
Trump's absurd plan shows once again the fallacy that we can take beneficial policies and detrimental policies and combine them into a reasonable compromise. Good policy for big insurance companies means bad policies for hapless patients and families.
Under a well-designed 'Medicare for All' national insurance program, plans like these would not exist. The sooner we get to national single-payer health insurance, the better it will be for all of us.
20
Remember these oldies but goodies from Trump?
"We're going to have insurance for everybody"
"I was the first and only candidate to state there will be no cuts to social security, Medicare and Medicaid."
"We don't want anyone who currently has insurance to not have insurance."
"...nobody will be worse off financially..."
"I am going to take care of everybody...Everybody's going to be taken care of much better than they're taken care of now."
"[Trumpcare]...it's going to be a thing of beauty."
How's that working out?
7
@F.Douglas Stephenson, LCSW, BCD The government is very sly about it, they will wait until days before the election to make sure people will not find out what an ugly game the Republicans play with them.
The government is our enemy, it is milking us, the people for personal gains as if we, the people, are their cows.
1
A complete sham, the general public simply cannot tell the difference
Thank You Republicans!!!
9
@John M Republicans aka Trumpists, are the sham artists aka conmen.
Good luck, Trump fans. Too bad you weren’t warned.
Right ???
11
These cheaper, fake insurance plans give a whole new emphasis to the phrase "penny-wise, pound foolish." And twitter lovers are unlikely to read fine print - or anything over one syllable.
10
@R. Anderson Smart people will know they have a better chance playing the lottery than getting the insurer to pay a dime.
1
The problem is that they are not really insurance. They're speculative bets on whether you'll experience a covered condition and only ensure that the provider gets paid a certain amount. If you run into a major health problem like cancer or a strangulated hernia with emergency surgery, you could be financially ruined.
16
Every developed country in the world has an affordable and comprehensive Insurance policy for all its citizens and not a single person gets bancrupt over medical bills.
Except the USA, where the medical costs per person are twice as high as in other countries.
Not all systems are single payer, in my country, the government, the Insurance companies and the health providers (doctors and pharma) sit around the table and negotiate what every Insurance company has to offer as minimum coverage (that would be equal to about a golden Insurance in the USA, no costs for doctor visits, prescribtion medicins physiotherapy, mental health and hospital visits/stays).
We (my wife and I) are both handicapped (my wife because of a brain tumor, I because of a grenate in Afghanistan, fighting alongside US troops) and we opted for the most expensive coverage, which costs each of us $150/month.
And the myth of long waiting lists, when I Phone my physician, I have an appointment the same day and when I need a specialist, she will make an appointment wqithin a week.
Why can't the US adopt a similar system????
24
@Rob It is called Socialism and you should know that is BAD.
Why not include all veterans and families in Tricare? Why the need of the VA for health care. The veterans could see their neighborhood doctors.
2
The insurers for these short-term plans have not been identified, it would be good to know who they are and how solvent they are before purchasing any plan from them. If these companies don't have the financial wherewithal to pay out for claims, the financial back lash for those covered could be significant. The last time the U.S. tried this short term stuff many of these companies filed bankruptcy to avoid paying for claims, leaving patients holding the bag.
11
When will the American people say enough and stand together?
When?
American productivity levels have increased tenfold. Corporate profits thru the roof. Corporate taxes slashed.
And we get the leftover crumbs tossed our way. Always grateful for the crumbs.
Did you forget that the Preamble of the COTUS says WE THE PEOPLE?
Read it. You might become inspired by the power of its intention.
Wake up! Stop hating each other and recognize the true enemy of the people. The Corporations.
My fellow citizens, South, East, West and North have a right to healthcare. If Corporations have a right to their obscene profits then we have a right to Universal healthcare.
If we care for our fellow American, and agree that no American should be denied Healthcare because they don't have enough $, then we need to stand together and demand it. For all.
This "health insurance plan " is nothing but straight up fraud.
Universal Healthcare for all is a no brainer.
When will we say enough?
19
Buyers beware: the ACA free screenings can find
"pre-existing conditions" that will never become cancer but will keep you from buying an affordable catastrophic policy. Been dealing with this for 15 years.
Middle class people need catastrophic policies again, mostly for accidents. My odds of needing expensive mental health treatment or prescription drugs in a given 12-month period are tiny. I have no family history of cancer. A one-year break from outrageous ACA costs would give me a chance to save some money for long-delayed dental treatment. I'm already trying to save for retirement at age 75 or 80.
I'm thrilled that affordable policies are coming on the market. Democrats, pay attention. Work toward providing options and fixing the market.
Push for transparency laws that will break up the log jam caused by providers and insurance companies who aren't telling consumers what their true costs will be so they can comparison shop in what the Republicans have made a consumer market.
I want Medicare for all but relief for middle class people on the individual market is needed NOW. Transparency laws will help.
2
The statement “I won’t need medical care the next 12 months.” is extremely short-sighted and fairly naive. You may not develop a deadly cancer but slipping on ice or being in a car accident can happens to anybody anytime. As a health care professional in orthopedic rehab I have seen it all. The healthcare system in this county frightens me. Don’t people realize that we are all in this together? Some of us may have better policies than others but the lack of transparency and now junk insurance that exclude more than they cover are unacceptable.
10
Just because insurance has a lower premium does not mean that it is "less costly." It means the insurance company has externalized risks and costs the insured now must shoulder. Just because the government spends less money today doesn't mean that we've reduced the Federal deficit. Reduced government expense offset by multiplied social costs to states, enterprises, and individuals is reckless and self-destructive. But the GOP (Guardians Of Privilege) has mastered the art of reducing taxes for the wealthy while multiplying future government deficits AND multiplying the current and deferred, but externalized, risks and costs for which we all will pay and suffer for many decades at the very least.
13
This isn't a health care plan and there shouldn't be any claim that that this is insurance. These policies don't meet the definition of health insurance under the Affordable Care Act and are being offered more to undermine the ACA than to provide a real purpose.
The President campaigned saying he had a healthcare plan that would "....cover everyone, cost less, and expand medical coverage"; he lied. This is nothing more than a money grab for these companies. Many Republicans ran on "repeal and replace" as a slogan but they have also come up empty. There are things in the ACA that need to be fixed but we need to face those challenges and not avoid them.
18
These dubious “health care plans” are the equivalent of buying a 200,000 mile, 10 year old vehicle off a questionable used car lot in the scruffy part of town. Who are the owners of the companies selling these awful policies? I suspect that the private equity/hedge fund crowd has sunk their rapacious claws into them. The low percentage of premium dollars actually spent on health care costs says everything you need to know about them. They are junk, providing a potentially devastating false sense of security to the unsophisticated and unsuspecting.
20
@John Grillo I agree these plans are the equivalent of buying a 10-year-old car with 200,000 miles on it. I actually own that car, which I barely use, and have a good mechanic who keeps it on the road. Thank you, public transportation and Lyft. I have options. Not so with health care.
I want a cheap health care plan for a year so I can pay for and save for actual health care. Complaining about bad temporary, one-year plans and not dealing with (to extend your metaphor) the outrageous cost of a new car or even nearly new car for someone who really doesn't need it, plus a tank of gas, gets you across town. It doesn't solve a very real problem of affordable health care for middle class people on the individual market that Democrats have been ignoring since the ACA passed.
2
@jlcarpen
Since shortly after the ACA passed, the Republicans have controlled the House and Senate and have put all their efforts into weakening the ACA while providing no actual replacement other than this fake coverage of cheap plans. Couldn't possibly let Obama have any sort of success. The corporate tax cut is another area where the Republicans played politics and never brought it up despite the fact that Obama had proposed it years ago. They preferred to slow the economic improvements which fortunately did occur anyway. Treasonous, if you ask me.
1
@jlcarpen But the dems were the ones who put single payer health care on the table back in 2009. It was the republicans who wouldn't pass it so the dems opted to compromise with a republican plan. ACA.
Dems haven't been ignoring the issues with unaffordable health care for decades. The R's have time and again and the D's are too weak (even when they have the majority) to steamroll Single Payer through for the benefit of the country.
Hopefully, when they do get the majority again, they have learned their lesson.
4
Pretend health insurance, like our pretend President.
39
On the surface, they may sound good, but when you read a little more, they really don't cover the things that you need health insurance for - costly major illness, with costly medications and costly hospitalizations that could happen any day of the week. If you knew that all you'd have was an occasional case of strep with a prescription for a z-pak you wouldn't need health insurance.
13
This isn't recognizable as insurance at all!
12
I was 39, healthy, never even broken a bone, never used my insurance and almost opted for lower coverage at multiple points in my life, then I got cancer. I had a good plan through my employer, paid a higher premium just in case, $42.00 a month.
Chemo > $100k x 3 =$300,000
Bone marrow transplant $1,000,000
Brain surgery > $100,000 x 2 = $300,000
Deductibles = $2,500 x 4 years = $10,000
I'm sure there are additional costs for medications, one was $10,000 a month and COVERED by our plan.
Before the ACA I would very likely have capped out at $2,000,000 level and been denied any additional insurance coverage. Most insurance previously had spending limits on coverage, thank you ACA.
I'm 44 now, on my wife's insurance and because insurance companies cannot deny me coverage due to my preexisting condition, thanks to the ACA.
Without a solid coverage we would have lost our house, taken on more debt than we would have ever been able to pay back. Going to an ER would have guaranteed initial treatment but in the end the cost would have been shared by other taxpayers at exorbitant ER rates.
The ACA is not perfect but is a good start, if encouraged and supported by the current administration could have truly been an amazing.
You don't know what you will be missing in these plans skinny plans until you need them, life can change in a moment. Make no mistake, this is a result in not reigning in big pharma and the downstream effects on healthcare providers/hospitals.
68
Not perfect neither is Obamacare. Yes, those who receive hefty subsidies are sitting pretty while those who are not eligible for subsidies often cannot afford health insurance.
We need to do better!
19
The high-handed paternalism of lecturing Us about what's best for Us, and if We don't know that it's because We're just not smart enough to, is grating. The reality of the ACA is it is/was flawed because it was based on the Massachusetts model, which in turn was a false sample set to work from. Here in MA we are a small state, with a small population, and are among the most affluent and healthiest populations in the US. The rest of the country is much sicker and less affluent. Surprise, the MA model applied to the US didn't work well. And that left young healthy people with the option of either paying crazy amounts for generous health insurance they didn't need, or paying the IRS a much smaller penalty. Now, at least, there is a third option, to pay a small amount for catastrophic medical insurance. That's a rational economic choice, not a fool's wager. And it should not incite supercilious finger-wagging of reproof.
8
@Beantownah
What you present as a rational economic choice is really no choice at all. People pick these short term plans not because because they want to but because they cannot afford ACA compliant plans. To me, we just need to raise the subsidies so the ACA plans are affordable and people will sign up for them. Yes, that also means more taxes and fees. The fundamental gulf between supporters of ACA and those opposed to it is that the former do not believe that income should determine access to insurance while the latter believe, like most consumer goods, income should play a role,
8
@Beantownah Hopefully, you're using the energy of your indignation to fight for better health care options than just advocating the horrible ones we have now.
6
I looked at some of these plans a year ago and found them to be lacking, primarily in drug coverage. All of the plans I looked at excluded in-patient drug coverage. That's notable since drugs administered in a hospital are potentially a large part of your bill.
I agree these plans are better than nothing, but for those looking into them, please be sure to download the entire policy and READ IT before signing up. DON'T trust a broker reaping a large commission, to have your best interests in mind.
9
@Bob Walters
Recently after an auto-pay screw up on the insurance company's end after a company buy-out, they dropped my $840 mo. private coverage. My prescription glaucoma drops went from $145 a month with insurance to $700 (!!!) without insurance. Fortunately I can get to Mexico where they're $50 and now piece meal 'short term' plans until Nov. open enrolment -- which is all crazy, inefficient and detrimental to my health.
I don't know how the rest of the country manages it . . . this is unacceptable and heartbreakingly cruel in "the wealthiest country in the world"!
8
The only potential advantage of "plans" like this would be if they provide medical insurance for those currently uninsured.
If they simply siphon off healthy,already insured people they make the current situation worse by increasing the cost to insure those remaining.
Medical Insurers add no value in our current system. They siphon off at least 10-30 % of premiums as profit and a similar percentage as 'administrative" costs.
Ostensibly their role is too exert pressure on medical providers to keep costs under control by preventing over-treatment and fraud. They are not succeeding.
We need to consider a single-payer system...but one focused on quality of care not quantity. Secondarily, such a system should have cost-control measures.
This "plan" is part of Trump's unconstitutional efforts to destroy Medical care in the USA. He should "take care" to execute his Presidential responsibilities.
10
@Brian Barrett-- Obamacare isn't really a good health care solution as it (a) subsidizes many but (b) leaves many more unable to insure because of the one-size-fits-all-policy Obamacare mandates.
It would have been so much better to not have given in to pressure from the industry and given us what most advanced countries in the world have enjoyed for years: universal health coverage.
Cut out the middle-man meaning the insurance companies. Health care for people should never be for profit. What can and does go wrong is evident in this country.
15
Although I don't like these short term insurance plans for all of the obvious reasons: they siphon off healthy consumers and often fail to provide the necessary insurance. However, there is a not insignificant number of people (5-10 million?) not otherwise covered by employer plans - and earning between about $70,000 to $125,000 - who are too wealthy to qualify for subsidies (or only qualify for minimal subsidies) but not rich enough to pay the $10,000 to $15,000 in premiums for a family plan plus the usual $10,000 deductible. What are these people supposed to do for insurance until these plans are better subsidized or we adopt a Medicare for All type program? People cannot be expected to pay for something that they cannot afford.
15
@Schneiderman,
The problem is that people who make $70k-$125k might own property, might have other means that will be taken if these "lightly regulated" i.e., unregulated insurance doesn't cover your illness. So you might save money in the short run, but in the long run, unless you don't own a home, and don't care if you get treated, you are deluding yourself into believe you have health care, when in fact, you do not! Friend bought one of these, had a heart attack, and had to make a 100k settlement because it wasn't covered. Good luck with that!
7
@Schneiderman Exactly. We found ourselves unable to pay an annual $25,000 insurance. It really isn't fair when one segment of the population enjoys free or almost free healthcare while others, not rich, just slightly better off, are expected to pay such a huge amount. More money for health-care than, in fact, for a person's mortgage.
The Democrats had a historic opportunity to give us single player but they caved in to the demands of the healthcare/insurance industry. Pity. Loading up a policy with everything from maternity to drug abuse naturally drives up the cost of a policy. Those who get a subsidy, well, they don't care. It is not coming out of their pocket. Obamacare brought in a new segment of society to insure but left many hard-working people unable to pay for insurance. So flawed. And so wrong. Especially in a country where "fairness" is so often brought up.
13
@Don Juan
Two points. One, single payer was not considered because even with a substantial majority in the House and a filibuster proof Senate (until Ted Kennedy died) there was not even enough support among Democrats for a public option, never mind single payer. Two, President Obama was very clear that the subsidies were capped at 400% of poverty because to not do so would have added tens of billions of dollars a year to the cost and Republicans were already harping on the cost issue. In retrospect, the failure to have higher subsidies and caps (combined with some type of price control) was the biggest error.
I know individuals who have had these short term plans and have had a difficult time getting the coverage they paid for when they file a claim.
11
@Milliband: I've interviewed several such people for my work. They included two cancer patients in their thirties who learned that none of their care would be covered by their policies. Both of them fortunately were treated by nonprofit hospitals that gave them charity care.
9
In Trumplandia America less is more and nothing is everything.
13
These plans are clearly of limited value but some people may benefit from them for a period of time. Using a modified line from the pro-choice crowd, if you don't like these policies then don't buy one. But they may be of merit in some cases.
The ACA has many flaws due to any number of reasons, some simple, some complex. One of my biggest gripes was how people adopted the term "junk policy" if earlier plans didn't cover things like maternity or mental health care - yet some people either have no use for those provisions or just don't want them. That choice, which we're supposed to otherwise embrace, is fine.
I get the idea of cost spreading, but it hasn't worked well. Both sides have let to much policies and personality interfere with ANY sane discussion of it. And by personality, I refer to the former president - many Republicans want to dump the ACA because of their animus toward him, many Democrats view any changes as an insult to his "legacy" a modern laughable conceit; neither position serves the nation well.
11
The abject cynicism displayed by this administration and the republicans who support this is dismaying. They are hucksters at the highest level and the people who support them are no different than the crowd being scammed at the state fair by a snake oil salesman.
12
This is simply Donald Trump's version of Trump University applied to health care.
What is there to understand? Trump came up with this idea, and his ideas are always the same - You pay a lot and get nothing. Nothing could be simpler.
16
I applaud The Times for trying to educate the public on these plans. But I disagree with the presentation, which makes it appear as some kind of legitimate health coverage rather than what it really is: junk insurance.
Even the high-deductible plans offered by large employers aren’t much better. In the earlier months, you pay both hefty premiums and out-of-pocket fees to your health providers. The providers and insurers try to make you believe your premiums are giving you “negotiated rates,” in which artificially inflated charges are brought down to still-high fees. You almost wish for health problems so that you can eat up your deductible. Then, after the deductible is met, you go on a binge of end-of-the-year doctor visits and treatments to try and gain some value from your high premiums.
It’s a perverted system and The Times doesn’t help when it presents junk insurance as a legitimate alternative to real health coverage.
14
Nobody should buy these plans. They are in fact costly FOR WHAT THEY COVER. If you are paying $200 or $300 month for one of these plans, you would be just as covered for any real medical expenses as if you had burned the money in your driveway. If the choice is to be uninsured or throw money at one of these plans - with the illusion that you are covered for catastrophic expenses - go uninsured. Because that's what you are anyway.
11
Trumpcare is like a health lottery plan where you win the lottery if your illness is actually covered. And we all know the odds of winning the lottery - the house (insurance companies) always win.
11
Maybe they should list what IS covered. Sounds like it would be much simpler.
20
@Rick The only simple efficient government plan is blowing up other countries
2
This is and always has been JUNK INSURANCE - no real coverage - just the illusion of it and the insurance companies make out well by collecting the "lower" premiums and providing almost no coverage - BEWARE
7
AN INCREASE IN ABORTIONS may follow, as the ACA required insurance companies to cover birth control, but the religious right is dead against it, and against birth control. Right now, teen pregnancy is at an al time low. Thanks Republicans, for bringing unwanted pregnancies back into the picture.
13
Will these be available to residents of NYS/NYC?
These plans are as good as a diploma from Trump University!
However, there are a lot of people who are going to enroll and like the customized and limited coverage. Stupidity, greed and evil have no limits.
8
Bogus insurance for easily-conned people.
A big step backwards by Trump.
This is the 'better' and 'cheaper' insurance he dishonestly promised?
How many GOP congressmen will call their own children and encourage them sign up for this garbage?
14
Insurance is all about hope. With these plans, you are hoping that you don't get one of the uncovered illnesses. But, that's the thing about health--one day it's here, next day it's gone. You notice a mole on your shoulder and all at once you have skin cancer. You wake up one night with terrible stomach pains, and the next thing you know you're being rushed into surgery to fix a bowel obstruction. Your kid plays a game of football, and you find yourself in the emergency room getting a broken leg fixed. You meet a great guy, start dating and oops, you're pregnant! These plans offer a false sense of security to people who have never had a medical problem and hope they never will. But, as time goes on, your odds get higher and higher. Illness touches us all, sooner or later.
10
@Ms. Pea -- take preventive measures than you don't find yourself pregnant.
Obamacare only works for those who have to pay little or nothing. I don't know about you but I find shelling out at least $25,000 a year for healthcare unaffordable.
8
@Don Juan, look in your area for Justice Democrats. As part of their platform, they promise to push for Medicare for All. They also dont take corporate PAC funds, only small donor contributions. So they will respond to the voters, not big donors. There are other groups out there also that have similar platforms.
3
@Don Juan Indeed, those who came up with what has to be covered by every ACA policy ignores the fact that some people are not going to get pregnant or need expensive mental health care or drugs in a one-year period (if ever). The fact that you can change policies every year has to factor into how they're written.
It's so sad that many Americans can't afford good health care. The USA is the most powerful and richest country in the world yet many Americans will have short term plans with Swiss cheese coverage that doesn't cover prenatal and maternity care or hip replacement or hernia surgery or injuries sustained while playing organized sports. So for example a parent will need to explain to Johnny that he can't play on the recreational soccer or little league team or in high school sports because their insurance won't cover injuries. Is this what it's like to be making America great again because it sure doesn't look like it.
11
@P Lock -- it would be better if Johnny took math lessons and other courses that help him in the future rather than play sports that can hurt him. In this country we play too much emphasis on sports rather than education, especially math and the sciences.
The reason Obamacare is so expensive that it covers everything. But there is certain care that should require a separate policy. Such as pregnancy care, hip replacement, Type2 Diabetes (it can often be reversed if person changes his/her lifestyle)
Drug addition treatment should require a separate policy as well. It's not something that is visited on a person but rather the person created this problem. Ditto for smoking and alcohol addiction. Ditto for bariatric surgery.
What should be covered: Checkups, Preventive care (this plays such a small role in this country), accidents, cancer, and the like.
3
@Don Juan Obamacare policies do charge a penalty for smokers. The items you're listing would do little to change the price of Obamacare policies. About 80% of the costs of treatment are consumed by about 15% of the pool; primarily those with very high cost conditions like cancer, heart disease, AIDS, renal failure and other organ failure, serious accidents, etc.
Given obesity contributes to some of these conditions, I would agree that a penalty for obesity makes sense, so long as there is no underlying conditional causing it.
The question I have is, what kind of application does one have to fill out to get a short term plan?
A major advantage of unconditional coverage is that it vastly simplifies the application process. I believe that under ACA, one needs only to supply their age and whether they smoke when applying for coverage. This very simple process makes it possible to compare apples to apples when shopping for healthcare.
If a plan wants to exclude pre-existing conditions, I would imagine any applicant would first have to fill out a massive form that details their personal health history, and to do that for each plan they want to compare. Perhaps brokerage houses simplify the process. The whole thing seems like a huge pain compared to the ACA website.
6
@Chris Bartle
Before the ACA insurers often did their underwriting at time of claim. In other words when a claim is submitted an extensive examination of the claimant's health history is begun to see if the insurer can deny payment due to a preexisting condition. So the application needn't be that extensive just the fine print wording of exclusion for preexisting conditions.
5
I like this idea of an à la cart plan. I don’t need pregnancy coverage, rehab coverage, or sports injuries coverage. I should be able to tailor a plan according to my needs and one that is priced accordingly.
9
@M
Would you be amenable to a Medicare For All program where everyone earning up to $150,000 AGI pays no more than 5% of AGI based upon a payroll tax? I acknowledge that I don't know if that would raise sufficient revenue but the concept is that people should have access to Medicare type benefits based upon an ability to pay.
5
That is nice in theory, but what if you have a catastrophic illness or injury? Your treatment would blow through the coverage caps in very short order, if it was covered at all. Then, at the end of the policy term, the insurer has no obligation to renew the policy. You could be left uninsured and bankrupted, a problem no one in any other advanced country has to face. Having lived overseas in a country that provides universal, low cost coverage, and has a good economy with far greater benefits for workers than ours, I am saddened that Americans don’t know how bad we have it and how unnecessary it is.
42
You are pretty optimistic to believe you will never need rehab coverage.
The other issue with plans like this is that insurance companies have gotten very good at throwing people off of the plans if their treatment gets expensive. You may not be able to renew the plan if you got sick, or some insurance companies, back in the unregulated past, would actually cancel an entire plan, and only allow healthy people to re-enroll.
16
Medicare for All.
Spread the costs and the risks over the largest possible number of people. This is how insurance works, when it's designed to benefit people instead of protect enormous profits for a few. The rest of the world knows it; only here are we held hostage to profiteering from every aspect of healthcare.
47
We just have to bite the bullet and increase the subsidies for those above 200 % of poverty and increase the cap on subsidies from 400% of poverty (about $96,000 per year for a family of four) to 600% of poverty (about $150,000 per year for a family of four). Also, nobody should have to pay more than 5% of AGI. If this were to happen, these short term insurance plans would not gain much traction. My assumption is that everyone wants the best insurance and they are just limited in purchasing them because of income.
Yes, this will cost tens of billions of dollars a year extra in taxes ($40 billion?) but we can't have people go without good insurance. I know it's naive, but I would like to think that this can be achieved by a reduction in military expenditures. I would rather have the extra economic security in exchange for a marginal decrease in our physical security.
25
@Schneiderman - Actually, a modest 5-7% reduction in the $700 Billion annual Defense Dep't budget would pay for this. We as a nation have to decide if we want to pay for our own and our neighbor's HC costs. For the record, we could cut the bloated military budget by 40% and still spend way more than China or Russia.
30
@GTM
I couldn't agree with you more.
@GTM. Indeed. It is a political decision. The problem for the people is they do not get a seat at the table under this administration.
Unlike the ACA, these insurance “policies” were designed behind closed doors. Almost always, a lack of transparency means someone is getting ripped off.
Defense budget is so bloated, but it is essentially welfare for contractors who are well connected. Poor people? Way under-represented. Otherwise, this wouldn’t even be an issue.
1
Kind of like the payday loan industry: the illusion of having money, until time comes when you realize what you really signed up for isn't what you thought.
If you want health insurance, buy real health insurance - be nice if we all had Medicare to start with, wouldn't it?
50
@Chris
Perfect example! I'm up here in the boonies of north Missouri, & my family hails from Mercer County on the Iowa line--the *Trumpiest* county in the state according to a KC Star article. My husband & I had one of these policies back in the '70s (farmers--as independent businesses can find next to nothing, & that's what this is)...young/healthy/20-something, but everything was out-of-pocket when I needed treatment for infertility.
Multi-generational farm families on both sides & married into one as well...somehow, even though these people have auto/farm/crop/home insurance, etc., there is this crazy notion that they can weather any health crisis because they've always been able to pay the DR--well, it's a whole lot different than when Grandpa gave the DR a steer or a load of hay in payment for birthin' the baby at home 80+ years ago.
Despite being The Show-Me State, Missouri is unwilling to move into the 21st Century & expand Medicaid/create its own Marketplace/etc. Blue Cross dumped those of us in the boonies (though they still offered some ACA options in metro KC), so I'm stuck with Ambetter from Centene in St. Louis...I consider it barely a step above the major medical my dad had 40+ years ago, and barely a step above what these new scam policies will be.
7
@Chris
Sorry but the return of the pre-existing condition exclusion will prevent many from getting anything at any price, it is an “EXCLUSION” from coverage not an opportunity to pay more. (The current lie being pedaled by the GOP to its deliberately ignorant base).
5
@Chris -- Medicare isn't free. It's income based. Even after a person retires and is on Medicare he/she pays a certain amount every quarter. Not chicken-feed for some.
9
This type of insurance was tried in the U.S. once before. When those insured started using their insurance, these companies filed for bankruptcy and the so-called insured were left holding the bag. Sort of like the same business model used by Trump. File bankruptcy in order not to pay your debts. Think about that.
82
The first red flag is the vastly greater profit margins of these plans. Then you get into the fine print that too often gets dismissed until you get sick. These plans serve cynical industtry and political goals, not the consumer who deserves refinement of the ACA - such as reducing the cost of care - not its destruction and a return to the bad old days of insurance profiteering.
29
Short-term health insurance is like decaf coffee: useless. Their main purpose is to help insurance companies make money.
To use another comparison, they're like gambling. A few people come out ahead, but most don't. The house always wins.
51
@Eric --Obamacare is also useless for people who do not get a subsidy and who cannot afford $25,000 a year before the insurance would have kicked in.
Either way, Obamacare or these new-fangled policies, many remain uninsured.
5
These plans are right for some people, but they need to be careful which plan they choose. Obamacare is financed by forcing the working poor and small businesses to purchase expense individual coverage; this forces the working poor and small businesses to subsidize coverage for those with pre-existing conditions. A Medicare for all option would be much more fair for everyone.
21
@Bruce - Right for some people? Who, the omniscient? What will happen tomorrow is always unknown - these plans are simple gambling with your LIFE with no payout. If you loose the bet and have a catastrophic health issue or an excluded health issue (reckless activity),then they will be all but useless.
All forms of insurance are based on subsidized coverage - ALL of them! Its merely a bet that the needs of the few do not overwhelm the resources of the many.
Lastly, I agree that Medicare for All/single payer is the right path. Why, because there are more to subsidize the needs of the few.
9
The systematic sabotage and dismantling of a good initiative to make health care more affordable and rein in the greed of the providers. This sabotage was perpetrated from day one, and accelerated under Trump. There is no perfect system, however, Scandinavia and other European countries show that healthcare can be universal and be more cost effective and have superior outcomes.
35
Be careful what you wish for. A guy I know had one of these cheap plans prior to the ACA. Both he and his wife were diagnosed with cancer just months apart. From his own mouth, he told me he owed $654,000 after the insurance paid what they owed through the policy.
He paid the bill by selling the farm which had been in the family for four generations.
84
Years ago I had one of these plans - called "Catastrophic Coverage" - and it's exactly what I want from insurance. Protection against high bills that might bankrupt me, at a cost that's commensurate with the low risk of that happening.
HMO-type coverage - a sort of all-inclusive "health maintenance" service offering many things I'd never use - is expensive and unnecessry for most.
Unfortunately, New Jersey and New York in their infiite wisdom outlawed these plans, depriving me of the opportunity to buy one. Grateful that they may be coming back!
9
@jkw These are NOT catastrophic coverage policies. Please don't conflate them. They pay out very limited amounts under very unusual circumstances. That's IF the insurance company does not cancel the policy when you submit a claim . . .
55
@jkw
True catastrophic coverage would have a high deductible after which there would be no lifetime or annual limit on benefits. Let the policy holder self insure for the small stuff but have comprehensive protection against catastrophic losses. Currently under the ACA such plans are available to people under 30 years of age. Why not allow these plans to be available to everyone?
11
@jkw "health maintenance" is something everyone should be taking advantage of if they're lucky enough to have that type of care covered. It's cheaper in the long run than neglecting yourself.
5
Finally. Thank you President Trump. My husband and I have been paying between $16,000-20,000 per year for our own policies. We have a small business and have never been eligible for any Obamacare care plans. Furthermore, the above came with $5000 deductibles. Since we have been relatively healthy, any doctor visits were additional out of pocket expenses until we reached that deductible. It has essentially been catastrophic coverage only discouraging any kind of preventive, outpatient treatment. Close to Medicare age, we do not need maternity care, birth control or acne care or prostate care (as a woman) for which we have had to pay. We will examine the short term plans closely but up until now we have been paying humongous sums for nothing.
31
@Deborah Exactly. you hit on the crux of the issue. Obamacare made the cost of health care for the middle class unsustainable. To this point no one seemed to care.
Also a bill in congress HS 6199 that will double contribution level for an HSA to $14,000.
12
Obamacare was attacked from its inception, and this is just more of the same. To get OC passed, compromises were made that damaged its core. As a result it never worked as intended. We can thank the medical industrial complex for that, i.e. insurance companies, for profit hospital systems and medical companies. No system is perfect, but many European countries show that you can have universal healthcare at equal or better quality for 40 to 50% less money. The main thing lacking there is the mahogany paneled waiting rooms with a Starbucks.
36
@Deborah
If you are close to Medicare age, then you are just the right age to get cancer. Your odds are 1 in 3 and your husband's are 1 in 2.
I was healthy, doing everything right, and diagnosed with stage 3 cancer. The first year of care was over $150,000. To date, close to $400,000.
Then, for younger people, one short viral illness can cause chronic fatigue syndrome, a serious illness affecting the immune system, endocrine system, nervous system, etc. You have zero chance of recovering without thousands of $ of tests and treatment, and most people never recover. It hits people of any age in the prime of health and 9ver 1 million Americans have it. Not covered.
And, then there are those sports related injuries which aren't covered, and now you don't want to fall after having a beer....
I foresee a lot more people going into bankruptcy and living (or dying) in misery with health problems they can't afford to get help for.
...and I and all the 81% of people over 50 who have pre-existing conditions are just hoping to have health insurance. You see, I lost my employer-based insurance because I can no longer work full time, and my husband is closer to Medicare age than I am, so whats left of the ACA market is where I'm headed...
The whole system needs to be fixed.
69
I know of an individual in Virginia who thought they'd save money by cancelling their ACA plan and getting one of these short-term plans.
Then they got cancer.
50
@Nicole Yeah. I just wish I had good news about the ACA plans. It seems like there are huge holes in their plans too. And then the hospitals try to game things by joining the network but hiring all of these out-of-network goons who prey on patients and send huge out-of-network bills. The patient thinks everything is in-network but then the hospitals say, "Surprise!!!"
13
@Nicole
That sounds a lot like an urban legend..."a friend of a friend...". Maybe it's all true, but sure lacking in details.
3
@No Name Please -- Exactly. I've read many articles about "out of network" doctors of which the patient knew nothing about and then had to pay out of pocket.
Also, the best hospitals and the best doctors are not in these networks.
So, paying an annual $25,000 before one gets afree doctor's visit .... it just isn't do-able for many.
1
My daughter was recently driving my 2007 Mercedes to work and was caught in a Flash Flood. The water came up to the top of the windows and stalled out the car. It wrecked the engine. I had full compressive coverage on my car along with a 2009 VW beetle My 23 year old daughter drove. We had 250/500k coverages. $50 k medical and uninsured. My insurance had just dropped to $600 per month from $800 when I first added my 17 year old. I own a home an have a home owner discount. I would never think about dropping the coverages. I live in an area, that last year the Gangs seemed to be stealing Mercedes E350’s of any vintage in the Atlanta area and going for joy rides. They would come up to the mall or right off the Highway and grab they from gas station. What do Babies trying to jump in know between a 10 year old an new Mercedes. Then I live in an area where the neighbor might be driving a 300k Mayback, I don’t need my kid backing into it, a $25 policy won’t cover a door, or the lost wages of the $25mill. NBA contract of the owner.
In the opposite lane was a 25-30 year old white male drive a Mustang that appeared similar vintage to our cars. It was a classic muscle car. The young man told me while waiting for his friend to see if they could get his car going. Told me he only had the minimum Liability coverage $25k, that cost him $180/month. The cop helped him push his car to a parking lot because it was standard. His friend but some oil and STP it started but it.
3
You have to review your situation every year.
6
These plans are essentially worthless if you think about it. They don't cover any likely big expense. Just save the premiums and use the savings to pay medical bills-- no insurance company administrative costs.
13
@JMcF
Or save the money to pay your burial costs. What you save will never over medical cost or paying for bankruptcy.
19
@JMcF "use the savings to pay medical bills" - that someone can never afford unless you are independently wealthy like say Mitt Romney. Otherwise, any relatively minor injury or illness will bankrupt you and your family.
Simple kidney stone ER outpatient event about $10K, knee injury falling off a step stool $50-100k, and a heart attack can quickly head toward half a million or more.
Save those nickles and dime for the immediate cremation ($750-1,000), it's a better bet.
9
The executives of the companies that offer these plans should have to have one as their only insurance.
67
@JsBx Yes, and all Republican Senate and House Representatives.
4
Of course these plans are cheaper. They are designed to NOT cover many of the reasons people need health insurance. Healthy people are playing the lottery when they buy these plans. Consumers would be better off spending time and energy supporting candidates for political office who support single payer medical insurance.
88
@EM Currently, what Democrat or Republican publicly supports single payer? It seems we have to throw out all the rascals. But considering the way our political system is set up we'll just end up with more the same, lining their pockets and serving their rich masters once the peons elected them into office.