Trump Administration Finalizes Rule to Allow for Skimpier Health Insurance Plans

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Along with all small businesses, they will now be able to get coverage from, for instance, their municipal chamber of commerce or national industry trade group, through the large group market. Among other things, the order called for loosening AHP commonality rules as one way to expand alternatives to the Affordable Care Act (ACA) exchanges and enhance competition in the market for health coverage.

However, the rule does allow payers and related organizations to consult or help develop AHPs by providing claims administration, formulary guidance, and provider network design.

The new rule will be phased in over the next year, beginning in September. In AHPs, members of the same industry, trade or professional associations can team together to form large groups with better negotiating ability than an individual business looking for health insurance coverage.

In addition, the new rule allows small businesses and self-employed individuals who are in unrelated professions, but in the same geographic region, to band together to obtain coverage through an AHP.

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SoHo-based health insurer Oscar said it will sell plans to individuals in nine states next year, expanding its exposure to the country's Affordable Care Act marketplaces as numerous country's major insurers retreat.

The U.S. Department of Labor is touting its latest reform as a vehicle to help millions of working Americans gain access to quality, affordable health insurance for themselves and their families. Numerous plans will be subject to the same rules as larger employers, which means they won't have to provide comprehensive benefits, such as maternity services, prescription drugs, or mental health care, mandated under the ACA. "They have bargaining power and they actually have fewer regulations than the small businesses". New plans can also choose to follow the new rules or the old guidelines, according to the DOL.

"AHPs are about more choice, more access, and more coverage".

When it first published the AHP rules in January (subject to a comment period of 60 days), the DOL noted that up to 11 million Americans working for small businesses/sole proprietors and their families lack employer-sponsored insurance and that these 11 million Americans could find coverage under this proposal. Acosta emphasized that the rules keep the same "consumer protection and health-care anti-discrimination that now apply to large companies".

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The administration is finalizing a second plan that allows people to hold skimpy "short-term" plans for a full year instead of limiting them to three months.

Acosta said that the final rule implements corporate safeguards and monitoring procedures to enforce anti-discrimination protections for AHP enrollees.

Trump himself has said AHPs will provide businesses with "tremendous insurance at a very low cost". States will continue to regulate them, although ASAE and others had pushed for AHPs to be exempt from state regulation.

Today, the Trump Administration released its final regulation on Association Health Plans expanding eligibility for these bare-boned plans, which do not have to provide the same level of minimum coverage as individual policies sold under the Affordable Care Act. It has estimated that average premiums for those buying small-group and individual plans will go up by 2 to 3 percent because of healthy people leaving those markets for association and short-term plans. 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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