An executive order is being finalized that would permit health plans offered by associations to allow individuals to pool together and buy insurance outside their states, a unilateral move that follows failed efforts by Congress to overhaul the health care system.
Soon after the latest Senate Repeal and Replace bill failed, Sen. Rand Paul (R-KY) said
“If [consumers] can join large groups, get protection and less expensive insurance … it will solve a lot of problems in the individual market.”
Even so, these plans have always been controversial.
In the past, some had solvency problems and went bankrupt, leaving consumers on the hook with unpaid medical bills.
In several states, regulators investigated whether the plans were advertising that they had comprehensive coverage when, in fact, they provided little or no coverage for such things as chemotherapy or doctor office visits. Kevin Lucia, a research professor at Georgetown’s Health Policy Institute said,
“They have history of fraud, of insolvency, of segmenting markets and there is often a loss of consumer protections,”
Read more in Kaiser Health News
Under the president’s proposed executive action, membership groups could sponsor insurance plans that cost less because — for example — they wouldn’t have to offer the full menu of benefits required under the Affordable Care Act. It’s unclear how the White House plans to overcome opposition from state insurance regulators, who see that as an end-run to avoid standards. Larry Levitt of the nonpartisan Kaiser Family Foundation said,
“There are likely to be legal challenges that could slow this effort down.”
Read the Associated Press story as published by ABCNews
Cori Uccello, senior health fellow at the American Academy of Actuaries said, Mr. Trump’s changes could
“cause a bifurcation of the market”
Insurers that offer plans under the ACA could face new difficulties, but companies also might find opportunities in offering new types of insurance. Mr. Trump’s order, described by a senior administration official, will include broad instructions for federal agencies to loosen rules on health plans that the administration says have driven up premiums and reduced insurance offerings available to people who buy coverage on their own or who work for a small employer. Read more in The Wall Street Journal (subscription may be required)