Jun 26, 2018
The Trump
administration on June 19 issued the long-awaited final rule aimed at expanding
access to association health plans (AHPs) that are not compliant with the
Affordable Care Act (ACA). A day later, the New York and Massachusetts
attorneys general said they intend to file suit to safeguard ACA protections.
As the situation plays out, industry experts assert that health insurers
generally have reason to view AHP market expansion in a favorable light.
Leerink analysts
describe the final rule on AHPs as “a positive” for managed care organizations,
“creating a viable market for about 4 million lives.” This total includes up to
400,000 individuals who currently lack health insurance, according to recent
estimates, the analysts said in a June 19 note to investors.
Sean Creighton, vice
president in the policy practice at Avalere Health, suggests that insurers can
grab hold of such opportunity “particularly if they can figure out…the correct
relationships with legitimate AHPs that are in the business of aggregating the
risk pools across various regions or industries.” He notes that there is a lot
of interest from the brokerage community in the formation of AHPs.
Creighton offers
cautious optimism for plans as events unfold. “I think it’s fair to say the
small group provisions under the ACA haven’t been too successful, so doing
something in that space isn’t the worst thing in the world,” he says. “But
doing it this way [i.e., through expansion of AHPs] is an open question.”
In the end, Creighton
says the rule may not go far enough on safeguards for AHPs. He cites a “history
of shady plans” in the individual market, though “a lot of them went away with
the ACA.” He adds, “I don’t know [that] the [Dept. of Labor] addressed that” in
the reg.
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