In the Wake of New Association Health Plan Standards, States are Exercising Authority to Protect Consumers, Providers, and Markets

By Kevin Lucia, Justin Giovannelli, Sabrina Corlette, and Christina Goe

This summer, federal officials issued regulations designed to encourage the expansion of coverage options that are exempt from key provisions of the Affordable Care Act (ACA). One of those rules makes it easier to form association health plans (AHPs) and offer this less regulated coverage to small businesses and sole proprietors. The new policy lowers federal standards for the formation and regulation of AHPs, while reaffirming that states have “broad authority” over these plans.

In their latest post for the Commonwealth Fund’s To The Point blog, CHIR researchers explore how states are using their authority to regulate AHPs to protect consumers, providers and health insurance markets.  They reviewed state regulatory approaches in 14 states and  found the following:

  • State regulation of AHPs created under new federal standards will vary significantly across the country.
  • While some states have required only that these plans satisfy the federal minimum standards, most are putting in place additional requirements, generally applicable to both in-state and national AHPs.
  • State’s approach to AHPs is likely to be informed by the condition of its individual and small-group markets and laws that predate the ACA, many of which arose out ofscandals associated with AHP fraud and insolvency.

To learn more about the ways that states are regulating AHPs to protect consumers, providers, and health insurance markets, please review the entire post here.

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