Association Health Plans: A Favorite GOP Approach To Coverage Poised For Comeback

Not even 24 hours after the latest “repeal and replace” proposal ran out of steam, Sen. Rand Paul (R-Ky.) ignited a new round of health policy speculation by predicting, during a cable news interview, impending Trump administration action on a longtime Republican go-to idea: association health plans.

“If [consumers] can join large groups, get protection and less expensive insurance … it will solve a lot of problems in the individual market,” Paul said last week on the MSNBC show “Morning Joe.”

Later, President Donald Trump told reporters that he would “probably be signing a very major executive order” that could affect “millions of people.”

But what does all of this mean?

While providing few details, Paul’s comments suggest the administration is considering changes to the rules surrounding these plans.

Under association health plans, small businesses can join associations — based on certain types of professional, trade or interest groups — that offer insurance to members.

Republicans for decades have favored such arrangements, seeing them as a way for small groups to get more clout with insurers.

As part of the effort to repeal the Affordable Care Act, GOP lawmakers this year tried, but failed, to pass legislation that would create new federally certified associations that could be sold across state lines with reduced state oversight.

Even so, these plans have always been controversial.

In the past, some had solvency problems and went bankrupt, leaving consumers on the hook with unpaid medical bills.

In several states, regulators investigated whether the plans were advertising that they had comprehensive coverage when, in fact, they provided little or no coverage for such things as chemotherapy or doctor office visits.

“They have history of fraud, of insolvency, of segmenting markets and there is often a loss of consumer protections,” said Kevin Lucia, a research professor at Georgetown’s Health Policy Institute.

– Kaiser Health News

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