U.S. Department of Health and Human Services releases rule paring back anti-discrimination provisions

On June 12th, the HHS Office of Civil Rights released a final rule聽re-interpreting anti-discrimination provisions of the Affordable Care Act. The new rule removes explicit patient protections against discrimination by health care providers and insurers. HFA joined with twenty-eight other patient and health advocacy groups to issue a statement聽expressing deep concern and continued opposition to the rule. The groups鈥 joint statement noted that,

鈥淏y finalizing these changes, the Administration tries to unwind significant advances that have ensured vulnerable populations, including individuals with pre-existing conditions, are free from discrimination and able to access healthcare. The elimination of these important protections will result in severe consequences for the health and well-being of Americans seeking health care, especially those with serious, acute, chronic or other pre-existing conditions and those in vulnerable and under-served communities.

鈥淢any Americans and their dependents will now be less likely to access preventive, diagnostic, and critical health care, or to enforce their rights to obtain such care. This is especially detrimental to the health and well-being of those living with pre-existing conditions, as well as women, LGBTQI+ individuals, people with disabilities, and those with limited English proficiency.

. . .

鈥淧articularly as the world confronts a global pandemic, these actions have no place within our system of care and put the public鈥檚 health at risk. Those that fear discrimination will be less likely to seek care and treatment for COVID-19. This puts the entire population at risk and undermines federal, state, and local efforts to control the virus.鈥

Ten days after publication of the final rule, a coalition of legal and advocacy organizations聽filed a lawsuit challenging the rule and its impact on LGBTQ individuals in particular. As this litigation proceeds, please remember that the ACA provides statutory protection against discrimination 鈥 protection that continues notwithstanding the provisions of the final rule.

Congressional Committee releases report on short-term health insurance plans

On June 25th, the Energy and Commerce Committee of the U.S. House of Representatives released a report outlining the findings of a staff oversight investigation into the expansion of 鈥渟hort-term, limited duration health insurance鈥 (STLDI) plans.聽 The report concludes that the expansion of STLDI plans 鈥減resents a threat to the health and financial well-being of American families, particularly in light of the current public health emergency.鈥 Among other things, the STLDI plans reviewed by the Committee:

  • Discriminate against individuals with pre-existing conditions (turning them down outright, charging them more, and/or denying coverage for their pre-existing conditions);
  • Don鈥檛 cover 鈥渆ssential health benefits,鈥 but instead limit coverage of such necessary health care items and services as prescription drugs, emergency care, and more;
  • Use unclear, aggressive, and/or misleading marketing materials and practices, so consumers may not understand what they are purchasing;
  • Offer inadequate protection against catastrophic medical costs; and
  • Limit coverage for illnesses and conditions that arise even after the purchase date, meaning that consumers who require health care while enrolled in one of these plans may incur potentially ruinous medical costs.

HFA has been warning the community about the dangers of STLDI plans for two years, since publication of a 2018 rule expanding the availability of these plans. You can find an infographic that summarizes the shortcomings of STLDI plans here.

Quick Hits:

  • On June 23rd, the Senate Committee on Health, Education, Labor, and Pensions held a hearing regarding recommendations to prepare for future pandemics. HFA in partnership with coalition allies signed onto two sets of comments submitted to the HELP Committee. Together with 22 other patient groups, HFA urged Congress to expand access to affordable, quality health coverage through private and public programs, thereby ensuring that people can access the care they need before and during a public health emergency. In a separate letter, HFA along with fellow members of the American Plasma Users Coalition encouraged Congress to adopt policies to protect a safe and adequate blood and plasma supply. The APLUS letter reminded Congress that blood and plasma products are lifesaving therapies for many, and noted that robust vigilance against blood-borne infections is essential.
  • On June 29th, the House of Representatives voted to approve the Patient Protection and Affordable Care Enhancement Act, H.R. 1425. HFA joined with 18 other patient groups in expressing support for the patient protections contained in H.R. 1425: expanding tax credits to lower purchasers鈥 Marketplace health insurance premiums; fixing the ACA鈥檚 鈥渇amily glitch;鈥 reversing the Administration鈥檚 rules promoting short-term health insurance plans; incentivizing action to expand Medicaid coverage by the remaining 14 non-expansion states; etc. Unfortunately, the Senate appears unlikely to take up the bill for consideration.
  • On June 25th, the U.S. Department of Justice filed its brief in the ongoing litigation over the constitutionality of the ACA. The DOJ continues to argue that the ACA鈥檚 individual mandate is unconstitutional and inseverable from the rest of the law 鈥 with the result that the ACA鈥檚 patient protections, Medicaid expansion, and more should fall, according to the Administration. Please remember that the ACA remains in effect pending the resolution of this lawsuit.
  • The month of June saw a lot of news on the state health policy front, too, ranging from the passage of step therapy protections (Louisiana) and balance billing protections (Georgia) to a vote on Medicaid expansion (Oklahoma). Look for a HFA report on state policy developments coming soon!


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