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eHealth gets jump on Trump's Obamacare alternative

  • eHealth will offer short term health insurance coverage starting next month.
  • The plans will offer fewer benefits, with dollar limits on medical coverage and do not include coverage for pre-existing conditions or preventive health services.
  • The plans also don't qualify for Obamacare tax credits and they do not satisfy the mandate that all people have some type of health coverage or pay a tax penalty.
  • However, some people who do not qualify for Obamacare tax subsidies find the lower monthly premiums appealing, eHealth said.

With Obamacare premiums set to see a big spike for 2018, online health insurance broker eHealth is betting that more people in the individual market will be looking for cheaper, more flexible plans that they can afford without subsidies.

"For individuals that can afford an Obamacare plan that's what they should buy … It covers everything from maternity to mental health. Our plans cover less, but they're also at about half the price," explained Scott Flanders, eHealth CEO.

Starting next month, the firm will be offering a package of short term health coverage in partnership with IHC Group and SASid Insurance Development in more than three dozen states and the District of Columbia.

"It's combination of short term insurance, gap insurance, and some fixed indemnity (but) it's one carrier … it's one bill, one place to file claims, one place to manage all their benefits," Flanders said.

John Connley, a Bentonville, Arkansas, general contractor, signed up for short-term health insurance last summer, after going without coverage for the last three years.
Oran Hardcastle | CNBC
John Connley, a Bentonville, Arkansas, general contractor, signed up for short-term health insurance last summer, after going without coverage for the last three years.

The plans offer far fewer benefits than requirements under the Affordable Care Act, with dollar limits on medical coverage, and do not include coverage for cover pre-existing conditions, or preventive health services. And they are not eligible for tax credits.

For 45-year old John Connley, that's not a problem. The Bentonville, Arkansas, general contractor said he signed up for a short term insurance plan this summer, after going without health coverage for the last three years. He earns too much to get any subsidies on an Obamacare exchange plan, and says the premiums are too high.

"It's a pretty standard 80/20 plan with a 20 percent coinsurance, and $1,000 deductible. I added dental and vision and it cost me about $150 a month," Connley explained. "If I go into (an ACA) compliant plan they're in the high $300s, roughly $400 a month, for the same plan."

President Donald Trump signed an executive order this month that could pave the way for more insurers to expand into the non-compliant off-exchange market. His order could reverse an Obama administration policy, which went into effect this spring, limiting short term insurance contracts to just three months at a time.

UnitedHealth Group has largely exited the exchange market, but executives of the nation's largest insurer told analysts they see potential for renewed growth in the short term insurance market, if the Obama administration limitations are reversed.

"The reality is before that regulation we saw incredible increase in the growth (of these plans) as the cost of exchange offerings have grown, and it's been a bridge for people … hopefully the duration of those plans gets extended," said Daniel Schumacher, president and chief operating officer of UnitedHealthcare's insurance division on the company's earnings conference call.

Trump's moves to undo the Affordable Care Act and recent comments declaring Obamacare dead may also drive more people to look for alternatives beyond exchange plans.

"With all of the changes from the president … there is a lot of market instability and premiums are going to rise considerably, so there may be more unsubsidized people that are going to be looking to see what their other coverage options are," said Caroline Pearson, senior vice president at health-care consulting firm Avalere.

"This represents an appealing potential business opportunity (for insurers), which might make them push harder to get uptake, including stronger incentives for brokers," Pearson said.

EHealth's CEO says launching the new short term insurance during this year's open enrollment was matter of providing their customers with what they've been asking for.

"The executive order has probably sowed more confusion about whether Obamacare is still available ... (judging from) some of the conversations we have with our consumers," said Flanders. "In the future, what it could do is open more options … 80 percent of our customers say, they don't want to have to buy a one-size-fits-all product."

But critics have charged that the limited coverage offered by the short term plans can leave consumers under-insured in the event of a major illness, and that the plans do not offer protections against being dropped for pre-existing conditions. In addition, because the plans are not ACA-compliant, consumers still are subject to the individual mandate tax penalty.

Connley admits having to pay the Obamacare penalty could wipe out much of the savings his plan offers, but that's a risk he willing to take to keep his payments lower.

"I'd rather stay out of the government insurance, and I can keep that money in my pocket through the year," he said.