health care policy

Group Health Plan Rules Struck Down

By Larry Hannappel  

For anyone following health care policy, the last days of March were as wild as they come.  

A few days later, a federal judge ruled against the Trump administration’s pursuit of work requirements in the Medicaid program via state waivers.  

Then, one of President Trump’s health-care initiatives, designed to offer a cheaper alternative to Obamacare, suffered a crucial defeat when a judge ruled the policy violates the ACA. 

Got all that? It’s a lot, right? 

Let’s focus here on that we think might be the most important of the three developments above, at least in the short term. Here’s what happened: 

U.S. District Judge John Bates in Washington blocked the rules governing so-called association health plans, or AHPs. These plans let businesses and individuals band together to create group health plans that offer less expensive coverage than the ACA — albeit without some of its protections. 

“The final rule is clearly an end-run around the ACA,” Bates, a 2001 appointee of Republican president George W. Bush, said in his ruling. “Indeed, as the president directed, and the secretary of labor confirmed, the final rule was designed to expand access to AHPs in order to avoid the most stringent requirements of the ACA.” 

While association health plans are bound by some ACA protections, they don’t have to adhere to a minimum set of benefits. The plans can also use demographic factors such as age, gender and occupation to set premiums. 

Supporters of AHPs, however, argue these policies offer them more affordable coverage. Some AHP plans are already in the market, with offerings from UnitedHealth Group Inc. and Anthem Inc. either available now or on the way. 

So, what’s next on this front?  

The Justice Department said it was “considering all available options” to respond to the ruling.  
 
“The administration will continue to fight for sole proprietors and small businesses so that they can have the freedom to band together to obtain more affordable, quality healthcare coverage,” the agency said in a statement. 

In other words, nothing is settled, so look here for updates as developments unfold.