A year into Donald Trump’s Presidency, the promise of repealing and replacing Obamacare is starting to take shape.  With Congress unable to repeal the 2010 law on their own, the Trump Administration has taken a more hands on approach in recent months, including repeals of penalties for people without insurance and a retooling of small business insurance offerings.  According to a recent New York Times article, a new proposal under the administration “would allow small business owners, their employees, sole proprietors and other self-employed people to join together as a single group to buy insurance in the large-group market.”  These new health plans would be exempt from some Obamacare requirement, not having to provide  certain “essential health benefits” like mental health care, emergency services, maternity and newborn care and prescription drugs.

While the new proposal is getting support from two well known trade groups  (the National Restaurant Association and the National Retail Federation respectively), others including consumer groups, state officials, and Blue Cross Blue Shield are letting their opposition be known. For the opposition, Association health plans “tend to attract employers with younger, healthier workers, leaving behind sicker people in more comprehensive, more expensive plans that fully comply with the Affordable Care Act. That could drive up premiums, which already have risen steadily as Republicans have taken aim at President Barack Obama’s signature domestic achievement.”

The Trump administration is fighting back on this push, claiming that the new proposal will include protections for high risk individuals. “Small business health plans (association health plans) cannot charge individuals higher premiums based on health factors or refuse to admit employees to a plan because of health factors,” such as a physical or mental illness, disability, claims history or genetic information.”

The claim sounds good in theory, but many have already admitted that the enforcing of this is next to impossible.  In closing, for those still debating which side is right in this, I want to leave you with an admittance made by the Trump administration as we proceed with the new proposal.

The department acknowledged that association health plans had a history of financial mismanagement and abuse. Some plans, it said, “have failed to pay promised health benefits to sick and injured workers while diverting, to the pockets of fraudsters, employer and employee contributions from their intended purpose of funding benefits.” The department said it now had the authority to prevent such abuses. But former employees said the department’s enforcement apparatus had been weakened by budget cuts and could not adequately police compliance.

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