Short-Term Limited Duration Plans and HIV
Short-Term Limited Duration Plans and HIV – 9205
President Donald Trump. Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States. October 12, 2017. Available at: https://www.whitehouse.gov/presidential-actions/presidential-executive-order-promoting-healthcare-choice-competition-across-united-states/; U.S, Department of Treasury, Department of Labor and Health and Human Services. Proposed Rule. Short-Term, Limited-Duration Insurance. 83 Fed. Reg. 55 (February 21, 2018). https://www.gpo.gov/fdsys/pkg/FR-2018-02-21/pdf/2018-03208.pdf
The Kaiser Family Foundation. (2001). How Accessible is Individual Health Insurance for Consumer in Less-Than-Perfect Health? Available at: https://www.kff.org/wp-content/uploads/2013/01/how-accessible-is-individual-health-insurance-for-consumer-in-less-than-perfect-health-report.pdf.
While CA and NY rank higher than IL and MD in terms of HIV prevalence, neither state sells products on Agile.com.
Kaiser Family Foundation analysis of CDC Atlas data, U.S. HIV prevalence. Available at: https://www.cdc.gov/nchhstp/atlas/index.htm
While HIV is highlighted as a condition plans are specifically seeking to avoid in selecting enrollees, many other past or current health conditions would be grounds for rejection from coverage. In addition, to HIV, answering affirmatively to any of the health condition related application questions would result in rejection.
In several circumstances, the HIV/AIDS application question mentions that, by law, residents of Wisconsin (WI) do not need to disclose their HIV status. To test this we also applied for plans in WI. Despite this disclaimer, the HIV/AIDS question is asked in the WI plan applications and the applicant must answer the question to move on in the process and ultimately, receive a coverage determination. If the applicant says they have been diagnosed with HIV, they are rejected from coverage. If they say they have not been, they are accepted but the applicant has then lied on their application, which could be grounds for rejecting claims or rescinding coverage. Online at least, there seems to be no way to avoid responding to this question despite the statement that WI residents need not answer it.
INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med. Jul 20 2015. Available at http://www.ncbi.nlm.nih.gov/pubmed/26192873; .S. Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. Available at http://www.aidsinfo.nih.gov/ContentFiles/ AdultandAdolescentGL.pdf. Accessed 6/7/2018.
Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011;365:493-505.; Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med 2016;375:830-9.;CDC. HIV Treatment as Prevention; updated November 2017. https://www.cdc.gov/hiv/risk/art/index.html
U.S. Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. Available at http://www.aidsinfo.nih.gov/ContentFiles/ AdultandAdolescentGL.pdf. Accessed 6/7/2018.
U.S. Department of Health and Human Services. Centers for Medicare & Medicaid Services, Office of the Actuary. Estimated Financial Effects of the Short-Term, Limited-Duration Policy Proposed Rule. April 6, 2018. https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/ActuarialStudies/Downloads/STLD20180406.pdf?elq_mid=11771&elq_cid=1094384
Pollitz, K., et al. (2018). Kaiser Family Foundation. Understanding Short-Term Limited Duration Health Insurance. Available at: https://www.kff.org/health-reform/issue-brief/understanding-short-term-limited-duration-health-insurance/