“Barebones plans will attract younger and healthier patients, who are likely to run up lower health care bills. That means those who buy traditional, full-coverage plans will be mostly older and sicker. With a risk pool composed of those who are likely to run up high costs, these plans will become very expensive and, as they continue rise in price, they may become so costly that no one can afford them. At that point, the market collapses and no coverage is available at all.” – Robert Field, PhD, JD, professor in the Dornsife School of Public Health and the Kline School of Law
The latest iteration of the bill Republican senators have been refining in recent weeks to replace the Affordable Care Act is a “step in the wrong direction,” according to Drexel University’s Robert Field.
Field is an expert in health care administration, policy and law who has closely followed the Affordable Care Act and Republican plans to supplant it.
And the latest version revealed Thursday introduces the possibility of allowing insurers to offer stripped-down health plans that cover less than what the current health law requires to be offered. It’s a measure that backers say provides lower premiums but Field sees as damaging not just to Americans looking for health insurance, but the market itself.
“It threatens to destabilize insurance markets and make coverage unavailable for many,” he said. “Even the insurance industry is against the idea.”
Skimpier health plans may seem appealing because they are cheaper. The reason they’re cheaper is because they are less expensive for health insurance companies to offer. And younger and healthier people who have few health care needs would benefit most from them.
“However, from the point of view of consumers, you get what you pay for,” Field warned.
Such plans would likely exclude some expensive services, such as maternity care, mental health treatment, or addiction help.
“And if you discover after you have bought one of these plans that you need a service like that, you will be out of luck,” Field said.
That would include anything from injuries to expensive illnesses like cancer.
“It’s like saying that as long as your house doesn’t burn down, you don’t need fire insurance,” Field said.
Such plans are also likely to carry high co-payments and deductibles with “very narrow networks of providers,” Field noted, which means that coverage could be limited even for routine conditions.
So how can premiums be reduced without a reduction in coverage, so that everyone wins?
Turns out, there may not be a clear way.
“If there were a way to reduce premiums and maintain the same level of coverage, someone would have thought of it long ago and gotten rich on it by now,” Field said. “As long as health care continues to grow in cost, someone has to pay for it. The only way to keep premiums affordable is to pool the risk, so those who are healthier, in effect, subside those who are sicker, or to have the government subsidize premiums for those with lower incomes. The Affordable Care Act does both of these.”
Media looking to speak with Field should contact Frank Otto at 215.571.4244 or firstname.lastname@example.org.