Medical

NY, Mass. AGs sue over Trump's Obamacare end-run for small business

NY, Mass. AGs sue over Trump's Obamacare end-run for small business

Many small businesses and their employees have struggled with government restrictions that limit access to quality, affordable health coverage.

The new rule does not affect previously existing AHPs, which were allowed under prior guidance.

Both the American Hospital Association (AHA) and America's Health Insurance Plans (AHIP) raised concerns that the plans lacked consumer protections.

The company showed signs of improvement in the first quarter of this year, earning a $2.8 million underwriting profit in NY. The core goal of an AHP is to allow small employers to band together and obtain coverage in the large group insurance market, which generally imposes fewer coverage requirements. They say the plans offer a way for people to take advantage of the group insurance market, even if they are self-employed or work for a business too small to provide insurance.

AHPs are not required to provide the essential health benefits (EHBs) package included in the ACA. "This association health plan rule is created to allow more businesses and self-employed workers to purchase junk insurance plans, further weakening Americans' health care and undermining essential health benefit protections".

The Trump administration said that antidiscrimination protections that apply to large employer health plans will also apply with the AHPs.




The plans must abide by the same protections for sicker or older Americans as those that apply to large companies, yet they wouldn't have to cover the full range of benefits mandated by the 2010 Affordable Care Act, so things like mental health or maternity care might be missing.

The Wall Street Journal reported that the expansion from Oscar, as well as similar plans by Centene Corp. and Molina Healthcare Inc., "reflect that many insurers' ACA business has moved into the black, after years of rate increases that have helped premiums catch up to costs".

The insurance company lost $127 million in the three states where it provided coverage past year, with much of its revenue covering administrative costs, such as spending to improve its technology.

The final rule allows fully insured plans to begin operating under the new rule on September 1, 2018. The final rule affirms this joint structure and does not reduce the "historically broad role of the states" regulating MEWAs, including AHPs. This allows them to retain some say in what benefits are offered and to monitor the financial health of the plans, depending on how the associations are set up. In addition, these plans purportedly must comply with the Mental Health Parity and Addiction Equity Act (MHPAEA) standards for behavioral health benefits that now apply to large employer plans (see Trump's Association Health Plans Will Be Like Big Employer Plans: DOL).

The rule also attempts to strengthen oversight of AHPs by requiring associations to have a formal organizational structure with a governing body and bylaws so they can act in the interests of participating employers and ensure claims are paid. "This makes the plans more affordable". That, in turn, would raise health insurance premiums for people buying standard coverage through the individual marketplace. Today, we are putting more power back into the hands of the American people to choose the health insurance plan that best meets their needs at a price they can afford. California announced this week that AHPs won't be allowed to operate in the state because they are considered as a type of Multiple Employer Welfare Arrangement (MEWA), which were banned in the state 1995.


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