The Trump Administration issued a final rule on Association Health Plans (AHPs), which was proposed earlier this year.  This is the first rule finalized after President Trump issued an Executive Order last year to “promote health care choice and competition” in the insurance market.  This final rule amends The Employee Retirement Income Security Act of 1974 (ERISA) , a federal law that sets minimum standards for health plans offered by employers, to allow small employers to join together to offer more affordable health insurance plans to their employees and  exempt them from some of the individual plan requirements.   “President Trump is expanding affordable health coverage options for America’s small businesses and their employees. Many of our laws make healthcare coverage more expensive for small businesses than large companies.  Association Health Plans are about more choice, more access, and more coverage,” said Secretary of Labor Alexander Acosta about the final rule.

While many are applauding the final rule, others are expressing concern and see it as a way for the Administration to undercut the requirements set out in the Affordable Care Act, such as protections for preexisting conditions or coverage of all services, such as maternity care.  There is concern that while this limited coverage will offer more options for individuals, it may not cover all that they need if they become sick, opening the possibility for high medical bills.

The final rule is effective 60 days after publication in the Federal Register, which is expected soon. It outlines a staggered implementation, based on the type of AHP.  Any existing or new plan may establish a fully insured AHP on or after Sept. 1, 2018. Existing associations that sponsored an AHP on or before the date the final rule was published may establish a self-funded AHP on or about Jan. 1, 2019 and all other associations new or existing may establish a self-funded AHP on April 1, 2019.

NACHC is in the process of reviewing the final rule and will continue to monitor this and other actions that might affect the health insurance market.