Community Health

Rep. Fulcher: Don’t Leave Behind ‘The Gap Population’

Plan to ban short-term policies would leave thousands uninsured
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What do contract employees, students taking a break from school to go back to work, employees working for low wages and those between jobs have in common? Known as “the gap population,” this group faces a unique difficulty when securing affordable, long-term health insurance.

For years, intervention from the federal government has prevented the market from providing healthcare options to these groups. Many in “the gap” earn too much money to qualify for Medicaid, but also can’t afford increased premiums in the individual market. The individual market is particularly expensive because “group rates” are not available. In the past few years, these individual premiums across the United States have skyrocketed. In Idaho alone, typical plans have gone from around $1,900 to more than $5,000.

Fortunately, short-term, limited-duration insurance (STLDI) plans have provided an alternative for those in “the gap” to secure primary healthcare coverage at a rate they can afford.

Although the STLDI option has been an overall improvement, the Affordable Care Act (ACA) mandated that these plans be changed as often as every 90 days, making it difficult for those in “the gap” population to maintain coverage or a maintain a regular doctor.

Idaho addressed this issue by establishing a rule to allow people to maintain their short-term health plan for up to three years. The Trump administration recognized the importance of Idaho’s solution to STLDI plans and announced a similar provision on the federal level, including a provision to ensure renewal options cover those with pre-existing conditions.

Despite these ongoing improvements to fine-tune and find solutions, Democratic leadership in the House recently passed legislation that would disallow the use of STLDI plans altogether.

According to the Congressional Budget Office, eliminating the STLDI option “would result in roughly 1.5 million fewer people purchasing short-term plans each year over the 2020-2029 period” and “about 500,000 would become uninsured.” Still, the fate of STLDI plans hangs in the balance.

While the fate of STLDI plans remains uncertain, I’ve met with health professionals throughout Idaho to hear their take on this issue — and our healthcare system as a whole. The feedback is clear: These professionals see value in STLDI plans that provide primary care needs. They know it is critical to have regular visits to your doctor, to catch problems early and to formulate good health habits.

I’ve worked on this at the state level for years and now am engaged at the federal level. Finding and promoting policies that make healthcare and health insurance affordable, accessible and of high quality is a complicated task. Ultimately, we must look past political posturing to help Americans get the care they need at a price they can afford. As we tackle new solutions, it is important to give credit to what IS working. STLDI plans are a step in the right direction.

Rep. Russ Fulcher (R-Idaho)

Congressman Russ Fulcher represents Idaho’s 1st Congressional District. He currently serves as the Republican Deputy Leader of the Natural Resources Subcommittee on Water, Power and Oceans; a member of the Natural Resources Subcommittee on Federal Lands; a member of the Education and Labor Subcommittee on Higher Education and Workforce Development; and a member of the Education and Labor Subcommittee on Health, Employment, Labor and Pensions.

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