Victory for Healthcare Reform!

July 12, 2018

You spoke, they listened: a new rule means more Americans will have better choices in healthcare.

The Department of Labor recently completed a rule that expands access to association health plans. This is the result of an executive order from President Trump aimed at promoting healthcare options in the US.

The idea behind association health plans is that small businesses and the self-employed with a common profession or interest, or those who share the same geographic location, can band together and be counted as a “large-group” (equivalent to an employer) for health insurance purposes.

As we pointed out in our previous coverage of the rule, the great advantage here is that “large-group” plans are subject to fewer mandates than under Obamacare – such as having to offer “essential health benefits.”  Large-group plans also have more leeway in setting premiums, which can be based on the health of the group (which is barred under the ACA for small-group plans).  Associations that gain large-group status could therefore offer less expensive coverage if they were made up mainly of younger, healthier members.

The final rule effectively allows association health plans to operate as an independent market, separate from the Obamacare exchanges, allowing more leeway to adjust to consumer preferences. This is an important step towards a more consumer-driven healthcare market that ANH strongly supports—although it is a step than could be reversed by the next president.

The Congressional Budget Office predicts that 400,000 people who would have been uninsured will enroll in association plans and 3.6 million people who already had coverage will move to association plans.

It remains to be seen whether the rule will stand up to legal scrutiny. New York and Massachusetts are already threatening to sue the Trump administration over the rule. But, as it stands now, plans can start being offered as soon as September 1.

Recall, too, that another final rule is in the works to lengthen the duration of short-term health plans from 90 days to a full year. These plans also do not need to adhere to Obamacare regulations.

With the failure of Congress to repeal or replace Obamacare with a consumer-driven alternative, we’re happy to see these important steps being taken to expand the healthcare options for Americans.

12 responses to “Victory for Healthcare Reform!”

  1. GraceAdams830 says:

    I hope this is an improvement.

  2. Viiper Freido says:

    So, essentially, this rule is saying that:
    1) you will probably not get access to “essential health benefits”
    2) the sicker you are, the more you have to pay.
    That doesn’t sound like healthcare to me. That sounds like a blank check for not actually getting any healthcare benefits. There is a reason that the “essential health benefits” are ESSENTIAL.

    • Arimathean says:

      Just because Democrats in Congess says something is “essential” does not mean it is really essential. Artificial contraception, for instance, is not essential.

    • Janis says:

      1. What constitutes as “essential health benefits”? Not everyone needs maternity care (men don’t), or mental health care, or addiction treatment. So why should people be forced to pay higher premiums for things they don’t want or need?
      2. It makes sense that people who are going to be spending more on medicine/doctors/hospitals should have to pay higher premiums. Otherwise, the company would be spending too much money on the sickest individuals and not profiting at all because the premiums wouldn’t be high enough to cover it. Healthy people shouldn’t be forced to pay higher costs just to help out sicker strangers. Some health problems are unavoidable. Exercise, eat healthy, Don’t smoke cigarettes, don’t drink alcohol, don’t use other drugs, don’t speed. Follow these rules, and you won’t need to see a doctor unless you have an accident. And if you’re a responsible person, you can save up money to pay for it yourself. Insurance is for people who don’t save. Yes, hospitals rip people off. The government should fix that problem instead of forcing everyone to have insurance. Insurance only perpetuates the problem of inflated medical costs. Hospitals adjust the amount they charge depending on which insurance a patient has. This is wrong. Cap medical expenses. Force COMPANIES to charge no more than a certain percent of a patient’s income, instead of forcing INDIVIDUALS to pay high costs for health insurance they may or may not want or need.

      • Peter from Dracos says:

        O no. The companies are still profiting under Obama care. The cost of forcing healthy people to pay for health insurance they theoretically won’t need (you said some health problems are unavoidable but then you immediately followed with preaching about how to avoid them) offsets the cost of sick people who desperately need those costs offset. It does not make sense for genetically sick people to pay higher premiums. I don’t like the medical system in the US in general but as to who will foot the bill for this rotten system? There is no good answer for that and people are likely to continue pinning blame on their fellow Americans rather than on the corporations, the federal reserve, and the career politicians where it belongs. Trump encourages people to blame each other so they don’t think of blaming him.

        • fondrees says:

          Obama was the most devisive president in history. Pitting blacks against whites, poor against the rich, woman against men, immigrants against non 8mmigrants. Give me a break. You are delusional. He campaigned on a pledge to be president of red and blu states alike. He did the opposite. A complete fraud.

          • Peter from Dracos says:

            Standing up for immigrants and the poor is not synonymous with pitting them against the rich.

    • fondrees says:

      I dont plan on getting pregnant anytime soon pal, how bout you? “Essential” health benefits will be covered..Elective health benefits will be covered as well, with a rider. Sorry, not paying dor your decision to have more kids

  3. Dust of the Earth says:

    My concern is that leaving the sickest people to have to bear the costs of their sickness by themselves (by allowing healthy people to jump ship) will not result in better healthcare. The sickest people are often poor (remember most environmental pollution causing grave sickness is located in poor rural and urban areas) so we cannot really expect them to be able to pay for it. I personally think all the industries causing grave sickness (coal power plants, chemical factories, industrial “agriculture”, etc.) should have to pay to restore the health of all those affected – maybe then they’d clean up their acts? Unfortunately, both an everyone-for-themselves and a single-payer policy have problems. Single-payer at least makes sure the poorest among us can get the care they need, but all too often the only care that’s paid for is pharmaceuticals and other conventional treatments. The consumer-driven ideal promoted by ANH only works when everyone can afford the treatment choices. A society that allows poverty is inhumane.

    • fondrees says:

      The poor are covered very nicely by medicaid. I share your concerns regarding healthy people jumping ship, leaving the sickies stuck as their group shrinks premiums skyrocket. There are equitable aolutions to this problem, but SINGLE PAYER IS A JOKE, it hasnt woeked well anywhere

  4. d-dectiri says:

    Wake up, this is our chance to change the downward spiral in health, not just health ‘care’… let’s find a couple insurers who favor functional medicine and get people to improve their health with treatment, not spiral down the side effects traps…. once we have some months of history, with lower cost treatments and fewer disabilities afterwards, the light should dawn on the rest of the insurers…… so let’s look at forming ‘associations’ of naturopathic practitioners to do a block of clients for such functional medical insured services….. the functional medical services use coaches to get people off their bad diets and start making progress…….. let’s roll……

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