Friday, June 29, 2018

Insurers See a Viable Market as Final Rule on AHPs Is Issued


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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