House Hearings Shed Light on a Key Policy Priority: Protecting People with Pre-Existing Conditions

After becoming a rallying cry in the midterm elections, pre-existing condition protections have taken center stage on Capitol Hill: in January and February, the House of Representatives held three hearings about protecting people with pre-existing conditions, before the Ways & Means Committee, the Education & Labor Committee, and the Energy & Commerce Subcommittee. As the ACA faces legal challenges in federal court, these proceedings set the scene for how this policy debate will play out in Congress and offer insight into potential legislative action. Continue reading

Short-Term Health Plans Sold Through Out-of-State Associations Threaten Consumer Protections

The expansion of short-term policies has raised concerns that they may be deceptively marketed, with some sellers leading consumers to believe they are buying a comprehensive policy when they are not. While twenty-four states have sought to regulate short-term plans, their efforts may be undermined by a loophole that allows the policies to be sold through out-of-state associations – a practice we found to be quite common. Continue reading

It’s All About the Rating: Touted “Benefits” of Association Health Plans Ignore Key Facts

A recent Washington Post article touted the emergence of association health plans under recent Trump administration rules, noting their lower cost and generous benefits. But the truth is more complicated, as CHIR experts Kevin Lucia and Sabrina Corlette point out, noting that AHPs often rely on medical underwriting and low “teaser” rates to lure new members. As a result, history is littered with insolvencies and even fraud connected to these arrangements. Continue reading

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

States have begun to respond to the Trump administration’s new rules for association health plans with a wide range of regulatory strategies. In their latest post for the Commonwealth Fund’s To the Point blog, CHIR researchers analyzed how states are using their authority to set association health plan standards and protect consumers, providers, and their markets. Continue reading

Virginia’s Enrollment Season Perfect Storm

Across the country, states are yet again dealing with policy changes just before the fall open enrollment season. Virginia, however, is a special case. The state is dealing with simultaneous implementation of Medicaid expansion, expanded short-term limited duration insurance and association health plans, and changes to the definition of sole proprietors for small employers, all with less funding for the navigator program. CHIR’s Olivia Hoppe breaks down how each change affects Virginians. Continue reading

The Trump Administration’s Association Health Plans Emerge: What Early Announcements Tell Us About this New Market

This past summer, the Department of Labor (DOL) finalized a regulation calling for the expansion of association health plans (AHPs) for small businesses and self-employed individuals. There continue to be significant questions about the impact of the rule, including how many associations will form, the role major medical insurers will play in AHP administration and marketing, and the extent to which AHPs can offer cheaper premiums than plans that must meet federal and state consumer protection standards. Now, with the rule for fully insured AHPs effective on September 1, we are starting to see AHPs emerge as groups take advantage of the relaxed requirements. Continue reading

House Farm Bill Supports AHPs with Federal Grants—Following in the Footsteps of the ACA’s CO-OP Program

The Farm Bill currently being debated in a House-Senate conference committee enables the Secretary of Agriculture to create a loan and grant program to assist in the establishment of agricultural association health plans (AHPs). The bill’s injection of federal funding for the purpose of creating new health insurance options is strikingly reminiscent of the ACA’s CO-OP Program. As Congress considers directing federal dollars into AHPs, we look back at the experience of the CO-OP program, which demonstrates just how difficult it is to build a new insurance company. Continue reading

When Policy and Politics Conflict: Challenges to State-level Market Stabilization Efforts

Within the last month, Delaware has adopted two policies with diametrically different effects on their small business insurance market. One would help make the market stronger and more stable, the other would do the opposite. CHIR’s Sabrina Corlette delves into some of the challenges facing states seeking to stabilize their health insurance markets during a time of considerable policy upheaval. Continue reading

Impact of Association Health Plans on Consumers and Markets Will Depend on State Approaches

In June, the U.S. Department of Labor issued a final regulation that implements President Trump’s executive order encouraging the expansion of association health plans for small businesses and self-employed individuals. Under these rules, professional or trade associations will be permitted to sell health plans that are exempt from many Affordable Care Act protections as early as September 1, 2018. To better understand how these new rules will affect states, CHIR experts interviewed six state regulators. Continue reading