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Guest Commentary | Short-term health plans: Playing roulette

These policies would be less expensive by not requiring plans to include the more-comprehensive benefits required for ACA plans, such as preventive services at zero cost sharing, prescription drugs, maternity care, and mental-health and substance-abuse services. Unlike ACA plans, short-term plans would not have to provide pre-existing-condition protections and could charge higher premiums or deny coverage altogether. Whereas the most popular ACA silver plans typically cover about 70 percent of health care costs, the new short-term plans would cover about 50 percent of the costs while providing fewer benefits. Expansion of these "stripped-down," short-term insurance policies would expand the prevalence of underinsurance by failing to provide adequate financial protection in the event of illness or injury. Expanding short-term health-insurance policies would not only affect the policyholder but also others with standard plans. How? Eliminating the financial penalty beginning in 2019 for not having health care coverage and this likely increase in the availability of more affordable short-term policies will attract younger and healthy people who feel they do not need the broader benefits provided by the ACA. Removing this group from the ACA risk pool would result in market segmentation and adverse selection, with those remaining being less healthy and facing higher premiums and plans being less affordable. The result would be an increase in the number of uninsured. Short-term health-insurance policies defeat the essence of insurance that requires a healthy pool of enrollees to cover those less healthy.

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