Competition Works, Even in Health Insurance
On Monday, I watched a fascinating discussion on Zoom that the Cato Institute hosted: health policy experts Michael Cannon of the Cato Institute and Brian Blase of the Paragon Health Institute discussing a Biden administration proposal to force people off short-term health insurance. It made me more aware of an insurance option that I hadn’t been aware of. The reason is that to the extent I pay attention, I do it as a parent helping my adult daughter find health insurance. But she lives in California, whose government, in its wisdom, bans such policies.
The big surprise I had was not that allowing a competitive option is good for customers. Duh. The surprise was that letting people buy these policies did not seem to drive up premiums in the Affordable Care (ACA) market. So allowing them is a double win.
Background
The 1996 Health Insurance Portability and Accountability Act (HIPAA) allowed state governments to have short-term limited duration health insurance (STLDI). The contract could last up to 364 days. But after the Patient Protection and Affordable Care Act (PPACA, henceforth ACA) was implemented in 2014, the Obama administration, concerned that healthier people would buy these contracts, leaving a sicker pool and, therefore, higher premiums and taxpayer subsidies in the ACA market, limited the plans to 3 months. This was implemented in 2016 and reversed by the Trump administration in 2018.
The Analysis
Being able to be insured for a whole year has been valuable to millions of people. And losing one’s insurance after 3 months can be catastrophic. Imagine, as has happened, that you have such a short term policy starting in January and you get cancer your first month. With a limit of 3 months, you get thrown off and can’t get an ACA plan until the next January. No insurance company pays the thousands or, more likely, tens of thousands, of dollars for your treatment. And that comes about not because of a big bad insurance company but because of explicit and intended government policy. That’s horrible.
So you don’t have to convince me that giving people this competitive option and letting them have it for a whole year is a good idea for them. Even better, these policies can be renewed twice so that you can be covered in one policy for 3 years. That means that if your health deteriorates during that time, you’re safe from new underwriting by the insurance company that adjusts for your higher risk.
Note the bitter irony. The heads of two presidential administrations said, “Our approach would preserve the right of Americans who have insurance to keep their doctor and their plan,” (Obama in 2010) and “If you have private insurance, you can keep it,” (Biden in 2019). Yet Obama took away private insurance from people with short-term plans and Biden proposes to do the same.
One thing that’s great about these plans is that in the states that allow them, people can buy relatively low-price insurance with deductibles that are lower than those in the ACA plans.
The Pleasant Surprise
Even though I like the idea of allowing people to buy health insurance and not be thrown off health insurance before they can replace it, I did buy the argument of the critics of STLDI plans that such plans would attract the relatively healthy, thus driving up premiums and taxpayer subsidies for the sicker people left in the ACA plans.
I still think such plans would attract the relatively healthy.
But here’s the pleasant surprise, from a study by health economist Brian Blase, president of the Paragon Health Institute and author of “Short-Term Health Plans, Long-Term Benefits,” September 2023. States that were favorable to STLDIs actually have had ACA rates fall between 2018 (when the feds re-allowed them) and 2023. States that were unfavorable to STLDIs either because their governments restricted the plans to 6 months or banned them (or made regulation so onerous that insurers chose not to offer such plans) had ACA rates rise or fall less than in favorable states. In states that banned such policies, the ACA rates rose the most. See Table 8 on page 11 for the empirical results.
How would you account for this? Here’s what Blase wrote in 2021, and quoted in his 2023 study, to explain that somewhat surprising finding:
The 2018 short-term plan rule may have, in fact, helped improve the individual market. This could have occurred because short-term plans forced insurers selling ACA-compliant products to offer more attractive products because of the added competition and because people with short-term plans who got sick or injured had short-term plans pay their expenses instead of moving to the individual market to get coverage to pay their expenses.
In short, it’s win-win-win for people with STLDI plans, people with ACA coverage, and taxpayers.
This letter to HHS Secretary Xavier Becerra, Treasury Secretary Janet Yellen, and Acting Secretary of Labor Julie Su from some heavy-hitting health policy economists and analysts gives more detail.
READER COMMENTS
steve
Sep 14 2023 at 11:24am
Seems like there is some potential for the free rider issue with these plans. Since they can offer limited coverage not normally required by the ACA they can be cheaper which works out well if the buyer doesnt get sick. If they do and cant pay then everyone else covers that for them. I dont see those costs in this analysis. Access to data on private insurance is generally not good so I dont think we know why costs for ACA plans in unfavorable states was worse.
That said, if we find that SLDI didnt just dump costs on everyone else and it really did lower costs by competition then it should be kept as it was. (I am a bit suspicious as the price differential, as I understand it, between STLDI plans and ACA plans can be large so I wouldn’t expect much competition per se and we dont know which plans are actually being bought. Link goes to cost comparisons and you could buy an STLDI plan at 20% of the cost of a bronze plan. You can also buy more expensive plans.)
https://www.kff.org/health-reform/issue-brief/understanding-short-term-limited-duration-health-insurance/
Steve
Dylan
Sep 14 2023 at 2:00pm
Thanks for the link, Steve. I was wondering why I hadn’t come across these before, and it looks like they are not offered in my state. Would have potentially been a good option for me when I lost my job earlier in the year. Instead, I had to hop through a bunch of hoops to get a catastrophic plan, since I’m over 30 years old. Catastrophic plans are actuarial equal to bronze plans, but (in my state at least) are about 40% of the price and are not subsidized. You are allowed to get one if you fall into an affordability exemption, where you’ve made too much money to qualify for subsidies, but the cheapest bronze plan will still be more than ~9% of your gross income. I’ve done it twice now, and the hoops you have to jump through to get one, means that almost no one actually gets these, which means that the people who sell them don’t think they are allowed to sell them. Took me about 3 months to get all the paperwork together and just finally got approved and enrolled in September. The plans are only good for one calendar year, so if I’m not employed by January, I’ll have to start the process over again.
One huge benefit is, because they are not subsidized, even if you estimate your income incorrectly, you don’t have to pay anything back.
steve
Sep 14 2023 at 4:06pm
I dont remember the details but there are some quirks, if they still exist, that let these plans be sold across state lines. You might investigate, but hopefully you dont need to know. If I can remember where I read it will post here.
Steve
James Howard sherrard
Sep 14 2023 at 10:18pm
I would think in these days of post covid, and a tight economy and low hourly pay without medical benefits. Short term health insurance would be a political plus for any party in the White House or wishing to gain the White House. The medical costs, medical insurance, and understanding Medicare is so complicated here in the United States it takes a PH. D so you don’t mess up or have financial penalties heaped upon you because you missed a deadline or made a mistake. Why does the Federal and State governments make it so difficult.
Comments are closed.