Minimal Insurance Products No Longer Considered Adequate Coverage

The Congressional Budget Office (CBO) recently declared that minimal insurance products—such as those that do not offer protection from crippling medical costs—are no longer considered adequate insurance coverage.

In a blog post on the CBO website, analysts Susan Yeh Beyer, PhD, and Jared Lane Maeda, PhD, both of the Health, Retirement, and Long-Term Analysis Division, wrote that minimal “insurance products would probably not provide enough financial protection against high medical costs to meet the broad definition of coverage that CBO and JCT have typically used in the past—that is, a comprehensive major medical policy that, at a minimum, covers high-cost medical events and various services, including those provided by physicians and hospitals.”

HealthcareDive reports that in the scramble to repeal the ACA, GOP lawmakers are now in the difficult position of providing a replacement that actually provides adequate medical coverage to Americans, equal to that of the ACA. This could exclude some high-deductible and health savings account reliant accounts—popular among Republican policymakers.

Another difficulty revolves around plans to replace the ACA with a tax credit, or coupon, for the purchase of health insurance. Dr Beyer and Dr Maeda noted that this could put Americans in the position of purchasing insurance plans that don’t actually provide what the agency considers coverage—ultimately costing the consumer.

“Everyone who received the tax credit would have access to some limited set of health care services, at a minimum, but not everyone would have insurance coverage that offered financial protection against a high-cost or catastrophic medical event; CBO and [the Joint Committee on Taxation (JCT)] would not count those people with limited health benefits as having coverage,” they wrote.

The agency also stated that “it counts only people with a comprehensive major medical policy as having private insurance,” when it defines and estimates coverage. —David Costill