The failure to repeal and replace Obamacare is regarded as perhaps the biggest legislative failure of President Trump’s first year in office.
Yet, Trump managed to eliminate the linchpin of Obama’s signature law, the individual mandate, through the tax-reform bill passed in December.
And now the administration is taking the first step toward implementing one of the most important planks of conservative health-care reform: allowing the sale of health insurance across state lines.
The Department of Labor published Friday in the Federal Register a proposed rule to expand the offering of small business health plans, also known as association health plans, reported InsuranceNewsNet.
Under the proposal, small businesses and sole proprietors would have more freedom to band together to provide health insurance for employees.
The proposed rule, which applies only to employer-sponsored health insurance, would allow sole proprietor and employees in small businesses to join together as a single group to purchase insurance in the large group market.
The Department of Labor said the move will result in more affordable health insurance.
The agency explained it will enable employers to reduce administrative costs through economies of scale, strengthen their bargaining position to obtain more favorable deals, enhance their ability to self-insure and offer a wider array of insurance options.
As proposed, the rule, which will be open to public comment for 60 days, would:
- Allow employers to form a small business health plan based on geography or industry. A plan could serve employers in a state, city, county or a multi-state metro area, or it could serve all the businesses in a particular industry nationwide;
- Allow sole proprietors to join small business health plans.
Under the proposed rule, small business health plans cannot charge individuals higher premiums based on health factors or refuse to admit employees to a plan because of health factors. The DOL’s Employee Benefits Security Administration will monitor these plans.
‘More choices for your employees’
In an interview with WND prior to announcement of the rule, Galen Institute President Grace-Marie Turner, who has been on the front lines of the health care debate since before the Clinton administration, explained the advantage of the association health plans.
“Let’s say you’re a small contractor or you run a barber shop or a beauty parlor. You really can’t afford to compete with the big guys in offering good health insurance to your workers. But if you were able to aggregate your policy with a lot of other similar businesses, then you can get the economies of scale. You could get more choices for your employees,” said Turner.
She said Trump and Republicans in Congress need to stay focused on even more health care policy changes.
“All the rules and regulations are still on the books about the kind of coverage that we have to purchase, the expansion of Medicaid to the point where many states are finding they can’t begin to afford their share of the costs of Medicaid; all of that is still on the books,” said Turner.
She noted Trump has a plan to offer expanded temporary health insurance.
The Obama administration allowed only one-time, three-month temporary insurance policies for people between jobs or going through other transitions. The Trump plan will approve year-long policies that can be renewed year after year.
She says states should be given more authority “to approve the kind of health insurance policies that people want to buy, to allow the market to work to bring more players into the market.”
“In many parts of the country, people are still only going to have a choice of only one plan. That’s not a choice,” said Turner.
Turner admits Republicans will be less motivated to address health reforms in 2018 since they repealed the mandate in the tax bill and want to avoid a repeat of of their Obamacare failures in 2017.
But she says “the voters are going to insist they take action this year.”
Republicans have about six months to get these reforms through Congress and onto Trump’s desk, she warns, otherwise the improvements will not appear in premium forecasts just weeks before Election Day.