This is a reminder, not all underwritten plans are junk plans.
cc: @bjdickmayhew @xpostfactoid @LouiseNorris @joshschultzdc @wcsanders Worth noting: CBO is kind of backing off from their December 2016 “Junk plans won’t be counted!” warning; they’re figuring 3/4 of #ShortAssPlans would be more like Grandfathered/Transitional? https://t.co/g35QCnGvgE
— Charles Gaba (@charles_gaba) May 23, 2018
The Congressional Budget Office (CBO)’s working definition of health insurance is a policy that provides reasonably protection against catastrophic medical expenses of most varieties. They’ll exclude plans with very low lifetime limits for what the insurer pays, or plans that pay a few hundred dollars per day of hospitalization or plans that only cover a particular disease class. But they will count plans that have some significant coverage of hospitalization and professional services with some type of exposure limitation.
As I have said before, when I worked at UPMC, the individual market underwritten plan was called GRIP.
GRIP is a medically underwritten plan that has grandmother (If you like, you can keep it) status. It is a good plan if you qualified for it. The network is the equivilent of the UPMC Premium network …The Gold equivalent (EPO $1000) for a perfectly healthy 40 year old male is $120 less per month than the Exchange Gold in zip code 15219….Fundamentally, GRIP, if one could pass the underwriting without any denials or upcharges is good insurance with a broad network and good pricing because the insured cohort is fairly unlikely to actually incur large claims.
Underwritten plans can be solid insurance.
The concern is that the bottom feeders will proliferate as they can offer a $30 a month plan with a $30,000 deductible, $100,000 out of pocket maximum and massive clinical exclusions. And the networks will be rented so that there is not even a significant benefit of in-network price discounts compared to cash-pay for individuals who incur some claims that are less than the deductible.
We just need to be clear in our thinking and our language when we talk about underwritten plans. Some of them are good. Some of them are okay in certain circumstances (young and male without behavioral health issues is the dominant circumstance with upside here) and some are pure junk. These distinctions need to be made going forward.