Maryland: Reinsurance bill also apparently slams the door on Trump's #ShortAssPlan scheme

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

A few days ago I noted that Maryland Governor Larry Hogan had signed a bipartisan bill into law which creates a $380 million reinsurance fund which should cancel out up to 21% of next year's looming individual market premium hikes.

However, I forgot to mention the other important thing that the same bill does: Evidently it would also head off Donald Trump's attempt to open the floodgates on the type of minimally-regulated "short-term" and "association" plans which would further damage the ACA-compliant individual market risk pool:

(C) THIS SUBTITLE APPLIES TO ANY HEALTH BENEFIT PLAN OFFERED BY AN ASSOCIATION, A PROFESSIONAL EMPLOYEE ORGANIZATION, OR ANY OTHER ENTITY, INCLUDING A PLAN ISSUED UNDER THE LAWS OF ANOTHER STATE, IF THE HEALTH BENEFIT PLAN COVERS ELIGIBLE EMPLOYEES OF ONE OR MORE SMALL EMPLOYERS AND MEETS THE REQUIREMENTS OF SUBSECTION (A) OF THIS SECTION.

(s) “Short–term limited duration insurance” [has the meaning stated in 45 C.F.R. § 144.103] MEANS HEALTH INSURANCE COVERAGE PROVIDED UNDER A POLICY OR CONTRACT WITH A CARRIER AND THAT:

(1) HAS A POLICY TERM THAT IS LESS THAN 3 MONTHS AFTER THE ORIGINAL EFFECTIVE DATE OF THE POLICY OR CONTRACT;

(2) MAY NOT BE EXTENDED OR RENEWED;

(3) APPLIES THE SAME UNDERWRITING STANDARDS TO ALL APPLICANTS REGARDLESS OF WHETHER THEY HAVE PREVIOUSLY BEEN COVERED BY SHORT–TERM LIMITED DURATION INSURANCE; AND

(4) CONTAINS THE NOTICE REQUIRED BY FEDERAL LAW PROMINENTLY DISPLAYED IN THE CONTRACT AND IN ANY APPLICATION MATERIALS PROVIDED IN CONNECTION WITH ENROLLMENT.”.

The short-term plan text pretty clearly states that STPs will be limited to no more than a 3 month period and can't be renewable (which is what the Obama Administration limited them to a couple of years ago).

The assocation plan language is a little more confusing to me out of context, but the lede of this Inside Health Policy article (paywall) seems to answer that question:

Legislation that lets Maryland place a 2.75 percent tax on issuers in order to fund a reinsurance program and restricts short-term and association health plans could be ready for the governor's signature by the end of the week, bill sponsor Sen. Thomas Middleton (D) tells Inside Health Policy . Middleton says the bill, which calls for an Affordable Care Act 1332 innovation waiver to create the reinsurance program, is supported by lawmakers including Gov. Larry Hogan (R), exchange and state...

So, congratulations, Maryland! You've checked off three items on my ACA improvement wish list in one shot!

In fact, I've decided to expand my ACA 2.0 status chart to include the latest developments in every state; here's what it looks like so far: