United States Government Accountability Office
Highlights of GAO-22-104683, a report to
c
ongressional committees
May 2022
PRIVATE HEALTH INSURANCE
Limited Data
Hinders Understanding of Short-Term
during the COVID-19 Pandemic
What GAO Found
One option that may be available to those who lose jobs with employer-
sponsored insurance (ESI) during the COVID-19 pandemic is short-term plans,
which can cover certain health expenses. These plans are generally not subject
to federal requirements for individual health insurance coverage established by
the Patient Protection and Affordable Care Act (PPACA), such as restrictions on
basing premiums on pre-existing health conditions and the requirement to cover
10 essential health benefits. Federal requirements for short-term plans are
primarily limited to defining their duration—the length of time a consumer can be
covered by them. States have broad authority and discretion in regulating short-
term plans, and regulation of short-term plans varies across states. For example,
some states have prohibited their sale and some have imposed restrictions in
addition to federal requirements.
GAO found that limited and inconsistent data hinder understanding of the role
short-term plans played during the COVID-19 pandemic for those who lost ESI,
such as whether they were used by consumers as temporary coverage or as a
longer-term alternative to PPACA-compliant plans. Policy researchers and
representatives of national organizations that GAO interviewed said there was a
lack of comprehensive data and information on short-term plans, including data
on how many people enroll in them and for how long. In addition, data collected
on short-term plans varied across the six states that GAO reviewed.
• Two states did not have data on short-term plan enrollment.
• Three states reported fewer than 10,000 enrollees in short-term plans and
trends varied as to whether enrollment increased or decreased.
• One state did not have short-term plans offered from 2019 through 2021.
State officials in the five states with plan sales were not able to report on the role
of short-term plans for consumers, as none of them collected data on the
duration of short-term plan coverage.
Views vary widely about the value of short-term plans to consumers. Officials
from two of the six states GAO reviewed and other stakeholders interviewed said
that short-term plans meet an important need for certain consumers who lost ESI
during the COVID-19 pandemic. They said short-term plans provide additional
options for certain consumers such as those needing temporary insurance until
they become employed again, and those who cannot afford insurance premiums
for PPACA-compliant plans. In contrast, officials in two other states and some
other policy researchers said that short-term plans did not provide good value to
consumers. While most of those GAO interviewed said that short-term plans
often had lower premiums than PPACA-compliant plans, some also emphasized
that short-term plans (1) provided fewer benefits, (2) were not available to those
with pre-existing conditions, and (3) could result in higher total out-of-pocket
costs for some consumers compared to PPACA-compliant plans. In addition,
unlike PPACA-compliant plans, short-term plans are not subject to federal
requirements to provide consumers with key information about their benefits that
would facilitate comparison with other options.
View GAO-22-104683. For more information,
contact
John E. Dicken at (202) 512-7114 or
@gao.gov.
Millions of Americans who lost their
jobs during the COVID
-19 pandemic
Short-term plan
insurance was one option for
these
consumers. However, these plans can
be significantly
different from other
options for those
g ESI. Therefore, it is important to
they play in the
market and for individual consumers.
under the
Coronavirus Aid, Relief, and Economic
Security Act for
monitoring the federal
government's pandemic response.
In
is report, GAO describes what is
-term plans and the
role that they might play for individuals
who lost ESI during the pandemic
.
takeholder views of the value of
-term plans in meeting consumer
are also discussed.
a literature search and
review of studies on short
-term plans
and conducted interviews with national
organizations such as the National
Association of Insurance
Commissioners.
GAO
policy researchers selected to
y perspectives
and
stakeholders. This included
six state insurance departments
different levels
s of regulation, and (2)
representatives from four organizations
that sell short
-term plans.