The Trump administration has found another way to try to undermine the Affordable Care Act’s marketplaces and force people out of their health insurance. It doesn’t take legislation when you’ve got the reins of government, and he and HHS Secretary Tom Price are using them. In this case, they’re plotting executive action to create work-arounds to siphon healthy people out of the markets.
Speaking to reporters Wednesday, Trump said he’s planning to issue “an executive order on associations”―a reference, most likely, to so-called association health plans, through which small businesses and in some cases individuals buy health insurance as a group. It’s possible that the federal government could allow some people to get cheaper, less generous coverage through these associations ― but only by taking healthy, working-age people out of the rest of the insurance market, destabilizing it and leading to higher costs for others. […]
Association health plans have been around for a long time, offering coverage to small businesses and individuals through trade organizations. Prior to the ACA’s enactment, they were subject only to state regulation, which meant their benefits and availability varied enormously.
The 2010 health care law lays down new rules for insurance companies selling to individuals and to small businesses ― like charging all consumers the same premiums, regardless of pre-existing conditions, and requiring that all plans include a set of essential benefits. President Barack Obama’s administration, through official “guidance,” made clear that all the new rules apply to the association health plans as well.
But the statute itself doesn’t state that explicitly, and the Department of Health and Human Services could attempt to reverse the Obama-era guidance, legal scholars told HuffPost on Wednesday ― in effect, exempting association health plans from some of the new rules. The National Federation of Independent Businesses, a conservative organization that has been among Obamacare’s most relentless critics, has urged the administration to take precisely this step.
So these AHPs, association health plans, would be able to offer cheaper and skimpier plans, getting around the guarantee of comprehensive health coverage for everyone which Republicans have developed a strong allergy to. They hate the idea that insurance companies have to actually provide what is commonly understood as insurance for everyone. Here’s yet another way they’ve found to create a loop-hole there.
Combined with all the other sabotage efforts—refusing to work with the states in enrollment efforts, refusing to provide funding for the enrollment programs, eliminating advertising for the new enrollments and cutting the open enrollment period in half, spending advertising dollars on campaigns undermining the law, and about 10 other things—the administration is hell-bent on doing everything in its power to make sure the law of the land fails.
In the long run, that’s only going to speed up our efforts to expand Medicare and/or Medicaid and get to a universal healthcare system. This baldly political and cynical effort to destroy the law is just going to drive up support for a more profound and complete overhaul of system, one that’s more bullet-proof and less susceptible to sabotage. That will be particularly true for all the people who get stuck with crappy insurance and then get sick, for the people who thought they were covered and are denied, and for everyone who is going to have to pay more for their insurance and their healthcare. But in the short term, it just means pain for more and more people.