Under Trump’s Proposed Rules, Small Businesses Could Band Together To Buy Health Plans
Republicans say that relaxing restrictions on association health plans will make coverage more affordable, but critics cite a history of fraud and abuse that has left employers and employees with hundreds of millions of dollars in unpaid medical bills.
The New York Times:
Trump Proposes New Health Plan Options For Small Businesses
The Trump administration on Thursday proposed sweeping new rules that could make it easier for small businesses to band together and create health insurance plans that would be exempt from many of the consumer protections mandated by the Affordable Care Act. As many as 11 million Americans “could find coverage under this proposal,” the Labor Department said in issuing the proposed rules, which carry out an executive order signed by President Trump on Oct. 12. The public will have 60 days to comment on the proposal before the Trump administration adopts final rules with the force of law. (Pear, 1/4)
The Washington Post:
Trump Administration Proposes Rules For Health Plans Without Certain ACA Protections
The proposal, issued by the Labor Department, would carry out the most significant part of an executive order that President Trump signed in October, directing the government to foster alternative types of insurance. Proponents say the association health plans would be less expensive and enhance consumer choice, while critics — including the insurance industry — fear they would promote substandard coverage and weaken the ACA’s already fragile insurance marketplaces. Specifically, the rules would allow such health plans to be reclassified so they no longer would have to include a set of 10 essential health benefits — including maternity care, prescription drugs and mental health services — that the ACA requires of insurance sold to individuals and small companies. (Goldstein, 1/4)
The Wall Street Journal:
Trump Administration Proposal Would Exempt Small Businesses From Some ACA Rules
[A] senior official said there are nondiscrimination provisions in the rule, a draft of which was released on Thursday, that would prevent an association from cherry-picking employers with healthy workforces or charging higher premiums to less-healthy people. An association couldn’t charge different premiums to different small employers based on health factors, the official said. But allowing the plans not to cover the mandatory ACA benefits could enable associations to essentially exclude people by not offering coverage for specific treatments, such as chemotherapy, said Timothy Jost, an emeritus law professor at Washington and Lee University in Lexington, Va. “There are plenty of opportunities for discrimination,” he said. (Armour, 1/4)
Modern Healthcare:
Trump Administration Proposes Rule To Expand Association Health Plans
Current criteria make it difficult for an association health plan to be regarded as a large employer under ERISA. So, many existing association plans are subject to the rules and standards that govern the small group and individual insurance markets. Those standards include protections for people with pre-existing medical conditions, and the requirement that insurers cover 10 essential health benefits. Members must be part of the same industry to form an association health plan under the current rules. The proposed rule would change that, allowing workers in unrelated professions to band together to obtain coverage through an association health plan so long as they are in the same geographic region, explained Chris Condeluci, a health policy consultant who was a Senate GOP staffer during passage of the ACA. (Livingston, 1/4)
Bloomberg:
Trump’s Obamacare Rule Would Let Small Firms Act Like Big Ones
Other Obamacare rules do apply though, including caps on how much an individual has to pay out of pocket in a year, and bans on lifetime or annual limits for services that are covered by the plan. All plans are also required to cover a list of preventive services with no out-of-pocket costs to the beneficiary. (Tracer and Eidelson, 1/4)
Los Angeles Times:
Trump's Move To Make Skimpier Health Plans More Available Threatens To Undermine Obamacare
[M]any patient groups and consumer advocates — who are already alarmed by Trump administration efforts to undermine the 2010 health law — fear that less comprehensive health plans will leave Americans without vital protections. "The rule proposed today will almost certainly result in more people facing financial distress when an unexpected health crisis happens and they discover their association health plan coverage is inadequate," said Chris Hansen, president of the advocacy arm of the American Cancer Society. By allowing healthier Americans to buy plans that don't cover expensive medications or other medical benefits, these plans also risk driving up costs for sick patients who need the more extensive coverage. (Levey, 1/4)
The Associated Press:
In New Rule, Trump Tries To Deliver A Health Care Promise
Don't look for revolutionary changes, said analyst Elizabeth Carpenter of the health industry consultancy Avalere Health. "The impact on the markets and on consumers really may depend on whether it is easy enough for the groups potentially affected to take advantage of the rule," she said. No sweeping consequences are seen for the more than 170 million Americans with employer-sponsored coverage, or the nearly 30 million still uninsured. (Alonso-Zaldivar, 1/4)
The Hill:
Trump Offers New Rule Going After ObamaCare
Republicans argue the proposal would give employers more flexibility to choose the insurance plan that works best. “If made final, this rule should help up to 11 million hard working Americans who don’t have access to employer sponsored coverage and in addition provide new, more affordable options to Americans in the individual market who are getting hammered by skyrocketing premiums,” Sen. Lamar Alexander (R-Tenn.), chairman of the Senate Health Committee, said in a statement.
(Weixel, 1/4)
Kaiser Health News:
Trump Administration Rule Paves Way For Association Health Plans
Critics, though, are wary about whether the plans will provide consumers adequate protection. “This approach allows associations to offer coverage that doesn’t have to come into compliance with all the critical consumer protections that would otherwise apply to small employers and individuals. It might not be as comprehensive,” said Kevin Lucia, project director at Georgetown University’s Health Policy Institute. (Appleby, 1/4)
Kaiser Health News:
Podcast: ‘What The Health?’ While You Were Celebrating …
The year in health policy has already begun: The Trump administration Thursday released a long-awaited regulation aimed at making it easier for small businesses and others to form “association health plans.” Now advocates and opponents will be able to weigh in with more specific recommendations. Meanwhile, in December, the health policy focus was on the tax bill and its repeal of the Affordable Care Act’s “individual mandate” penalty for most people who don’t have health insurance. But some recent key court decisions could reshape the benefits millions of people receive as part of their health coverage. (1/4)
