Tag Archives: Association of Health Plans

Trump administration appeals association health plan ruling

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https://www.fiercehealthcare.com/payer/dept-labor-defends-rights-small-businesses-to-expanded-health-plans?mkt_tok=eyJpIjoiTXpCbFpXWXpPR1JtTTJSayIsInQiOiIyUWdwd0NuaU9YSUFYcmg1UnlDUm84Tk4yXC8weWpLOG5hT0lXWHJSRjIzMllDUFZmU05XSFpKWmRrQ3R0NjhPV3VSbk5KTFVYbEdPMXZmMHF1Q0JRbCtRNzZzSWFPV1Y2N1hnMmpRVlNtS1wvNmRZSE1YREZnbUNLM3ZnMXE2ejhBIn0%3D&mrkid=959610

Gavel court room lawsuit judge

The Trump administration will appeal a judge’s ruling that struck down much of its rule expanding association health plans (AHPs).

The rule made it easier for an association of employers to establish an employee welfare plan—regulated under the Employee Retirement Income Security Act (ERISA) and the Affordable Care Act—as a single employer plan. In other words, small employers can work together with others in their industry or geographic area to purchase a larger health plan.

The Department of Labor filed a notice of appeal (PDF) Friday.

Eleven states and the District of Columbia filed a lawsuit saying that the definition of “employer” in ERISA was not reasonable. A federal district court agreed and set aside regulations for qualifying associations, saying that the Labor Department failed to put a limit on the types of associations that can qualify to sponsor an AHP.

“This appeal is welcomed by associations across the country who have invested their time, money and reputation to launch health plans under the 2018 regulation,” Kev Coleman, president and founder of AssociationHealthPlans.com, said in a statement. “This regulation marked a watershed in health policy inasmuch as it corrected a basic unfairness existing in health coverage costs between small companies and large companies.”

Critics, meanwhile, argue the plans offer skimpy coverage that can leave consumers at risk.

Currently, there are an estimated 30,000 small-business employees and their dependents using these plans. According to a 2019 healthcare survey by AssociationHealthPlans.com, four out of five respondents supported small businesses working together to offer large company health insurance plans.

In Congress, Sens. Chuck Grassley, R-Iowa, and Joni Ernst, R-Iowa, joined Sen. Mike Enzi, R-Wyoming, in introducing legislation to prevent small business employees from losing their healthcare coverage. The legislation would ensure a pathway for small businesses to offer AHPs under the Labor Department’s final rule.

 

 

 

 

House Proposal to Promote Association Health Plans Poses Risks for Insurance Markets, Consumers

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http://www.commonwealthfund.org/publications/blog/2017/mar/house-proposal-to-promote-association-health-plans-poses-risks-for-insurance-markets-consumers?omnicid=EALERT1182419&mid=henrykotula@yahoo.com

While the nation is focusing on the American Health Care Act, the most recent proposal to repeal and replace the Affordable Care Act (ACA), another Republican proposal is quickly advancing through Congress. The Small Business Health Fairness Act, H.R. 1101, allows small employers to band together and buy health insurance though federally certified associations. Despite its name, the bill would have a considerable and likely detrimental impact on the private health insurance market and undermine the ability of states to protect small employers and their employees.

The concept of federally certified Association Health Plans (AHPs) is not new. AHP proposals similar to H.R. 1101 are prominently featured in many of the legislative proposals to replace the ACA. Similar versions of this legislation were defeated in the early 2000s with opposition from a broad spectrum of stakeholders. One important critic, the National Association of Insurance Commissioners (NAIC), strongly opposes federal AHP legislation, including H.R. 1101, because the approach would “strip states of the ability to protect consumers and create competitive markets.”

H.R. 1101 would encourage professional and trade associations to offer health insurance coverage to their members nationwide. Proponents suggest that AHPs will offer lower premiums to members, primarily through increased bargaining power and fewer regulatory requirements. Under the bill, AHPs would be certified by the federal government and regulated under minimal federal standards for premiums, benefits, and financial solvency.1  In general, these federal standards would be less stringent than those required of insurers under state insurance law.

While some members of AHPs may benefit, this proposal would undermine states’ ability to regulate health coverage sold to their residents and to implement local standards and protections. Ultimately, federally certified AHPs under H.R. 1101 have the potential to negatively impact consumers and health insurance markets in the following ways: