On September 4, the Department of Health and Human Services (HHS) issued new guidance on expanded eligibility for Affordable Care Act (ACA) catastrophic health insurance plans. The guidance provides that individuals who cannot get premium tax credits or cost-sharing reductions via a health insurance exchange can now qualify for hardship exemptions under the ACA that allow them to purchase catastrophic health insurance. The expanded eligibility takes effect November 1, according to HHS.
Catastrophic plans offer consumers lower premiums and generally cover high medical costs that may arise from serious illnesses and injuries. They also cover preventive services required under the Affordable Care Act and up to three pre-deductible visits with primary care physicians. The exemption will apply to consumers purchasing plans either on or off the Exchange.
The guidance also simplifies the process, said HHS, by “streamlining the review of paper applications to reduce the administrative burden on consumers. This change will make it easier for individuals experiencing hardship and seeking a catastrophic plan to access the full range of catastrophic coverage options available to them.”
Prospects: NAIFA has long supported expanded access to catastrophic health insurance coverage. It is also an issue area being examined by Congress in the context of a health policy bill that may be offered in the weeks to come.
NAIFA Staff Contact: Mike Hedge – Senior Director – Government Relations, at mhedge@naifa.org.