Department Of Labor Publishes New Rule On Association Health Plans

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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".

"We remain concerned that broadly expanding the use of AHPs may lead to higher premiums for consumers who depend on the individual or small group market for their coverage", the trade group said.

"They won't make drugs more affordable, they won't help Americans get health care they need, and for every person who pays a slightly lower premium upfront, more goes to insurance companies and less of that goes to their care", said Andy Slavitt, who oversaw Obamacare in the previous administration. Secretary of Labor Alex Acosta on Tuesday said the new plans "will offer more health care coverage options at a better price".

But the plans will have more freedom to charge different prices depending on customer's age, gender and location - something ACA coverage can not do. "We will sue to safeguard the protections under the Affordable Care Act and ensure that all families and small businesses have access to quality, affordable health care".

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The final rule comes as a result of an executive order signed by President Donald Trump in October 2017. The DOL will share AHP authority and oversight with state governments. An existing trade association would be eligible to form an AHP, for example. Providers and related healthcare professionals would also be prohibited from establishing an AHP as a bona fide group.

The final rule broadens the definition of an employer under the Employee Retirement Income Security Act to allow more groups to form AHPs as an alternative to the Affordable Care Act (ACA) health exchanges.

AHPs can also only be formed if there is a "commonality of interest" among individuals looking to form a group. Some commenters argued that because those AHPs did not design their operations with the new requirements in mind, they "may not be able to comply with the new conditions without reducing existing options for affordable healthcare".

In a DOL example, if an association offers benefits to restaurant employees in a specific area, then it can not exclude the employees of a certain restaurant if the business's employees have higher-than-expected care costs. Commissioner Doak also testified before a U.S. Senate committee a year ago to address the actions Congress should take to stabilize and strengthen the individual health insurance market. States will have discretion around limiting AHP enrollment in relation to other non-health factors.

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In addition to providing more choice, the new rule makes insurance more affordable for small businesses, the department of labor stated.

The final rule effectively allows AHPs to be separate from the ACA health exchanges and operate as an independent market.

"AHPs' flexibility to offer products and premiums that more closely align with their members' preferences is a significant benefit for those members", DOL said. States will continue to regulate them, although administration officials had asked for suggestions on how to possibly exempt them from state regulation.

An analysis by Avalere Health in February projected that AHPs could lead to 3.2 million enrollees shifting out of the ACA's individual and small group markets into AHPs by 2022.

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The Congressional Budget Office estimates the rule will provide health-care coverage for four million Americans, including 400,000 who are now uninsured.

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