After the Graham-Cassidy health insurance legislation failed, President Trump claimed he would be signing key executive orders concerning health care.
According to CNN Money, Sen. Rand Paul (R-Ky.) may have revealed the possible content of those executive orders.
During a cable news interview, Paul suggested Trump might sign an executive order endorsing association health plans. Associational health plans have long been popular with conservative advocates for health insurance reform.
Association plans allow small businesses to join an association based on a particular type of group, like a trade group, professional group, or interest group. The associations offer health insurance to members.
According to Republicans, this arrangement would give small businesses more power in dealing with large health insurers.
Paul did not offer a lot of additional details. However, health care policy experts believe President Trump intends to exempt association plans for state regulation.
If the association plans were classified as large group plans instead of individual or small group plans, they would be exempt from many of the Affordable Care Act’s requirements. For example, the plans would not be required to offer coverage across the 10 essential categories established by the ACA.
Many of the Republicans’ previous attempts to repeal the ACA included provisos that would authorize associations to sell insurance across state lines.
In the past, similar companies went bankrupt, leaving their customers liable for thousands in medical bills. State regulators also discovered these plans often failed to provide anything remotely close to comprehensive coverage.
Kevin Lucia, a 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.”
Some health care policy experts are concerned that cheap association plans would disproportionately attract healthy consumers. This would force insurers who offer comprehensive coverage to increase their premiums.
The American Academy of Actuaries was concerned that “this could create an unlevel playing field.”
According to Sen. Paul, if regulations were loosened on associations, they could provide an attractive option to customers looking for less expensive coverage.