On October 12, 2017 President Trump issued EO 13813 stating that the Administration will prioritize three areas for improvement in the near term: association health plans, short-term limited-duration insurance, and health reimbursement arrangements. The EO was part of a broader effort by the Trump Administration to promote more choice in healthcare. Under the Order, the Department of Labor was directed to consider or revising existing guidance that would allow more American employers to form association health plans (AHPs).
In January 2017, the DOL proposed a rule that would broaden enrollment in AHPs and potentially increase health care choices for small businesses. AHPs allow those in small businesses to come together to act as an association for the purposes of providing health insurance at a large-group level, which can sometimes provide more value and reduced costs than plans for small groups. Generally, group health insurance offered by an employer with between 1-50 employees is in the small group market, while group health insurance offered by an employer with at least 51 employees is in the large group market.
As part of an AHP small businesses would be treated as part of the large-group market. In this way, AHPs provide another option for small businesses to provide more affordable health care for their employees. However, employers in the large-group market are not regulated under the ACA in the same way small-groups are and large-group insurance providers do not need to offer essential benefits like prescription drugs, maternity care, or emergency services.
The rule is open to comment from the public for 60 days, after which it will likely be adopted.
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