Feds move to close no-hospital coverage loophole

Federal regulators Tuesday announced plans to close a loophole in the Affordable Care Act that allows large employers to offer plans that don't cover in-patient hospital stays.

Paste BN reported Monday that the Centers for Medicare and Medicaid Services would do so.

To meet the ACA's "minimum value" test, health plans for individuals and those working for smaller employers must include coverage within at least 10 categories of "essential health benefits" that include maternity care, prescription drugs and hospitalization.The health care law is much more stringent about what health insurance must cover for these people than it is for those working at large employers.

Plans that cap the number of hospital visits or offer no hospital coverage were believed to pass the ACA's minimum value test if other coverage for doctors and prescription drugs was generous enough. But CMS is proposing that employers have to offer at least one plan that meets the minimum value test.

These plans were expected to appeal most to low-income workers because of lower premiums, but experts warned they could leave them without important coverage when they need it most.

The proposed amendments to ACA regulations would take effect in 2015, meaning some employees could still be offered these plans. But the CMS guidance says these employees could still go to the federal or state exchanges and buy plans with subsidies as the plans don't meet the minimum value.

Tell us your healthcare experience at healthinsurance@usatoday.com