Republican Senators announce health care plans that could exclude full coverage protections for workers.
Senate Bill 86 creates opportunities for small businesses to provide health care for employees using Association Health Plans (AHPs) authorized under federal guidelines. The Trump administration rolled out AHPs in June 2018, claiming they would result in lower prices and more choices for employers and employees. S86 would require coverage for people with preexisting conditions and allow parents to keep children on up to age 26.
AHPs don’t have as many consumer protections as other health plans. Due to this, economists and experts say AHPs are risky and likened them to “running with scissors.”AHPs do not have to cover the ten “essential health benefits” required under the ACA and could exclude coverage for prescription drugs, for example, and smaller employers could skip maternity coverage requirements. Protections written into AHPs for people with preexisting conditions would be weakened by plans that make chronic care patients jump through more hoops or pay high deductibles.AHPs cannot discriminate against sick individuals, but do not offer complete protections for people with preexisting conditions who could face “roadblocks in finding affordable, comprehensive coverage.”
S86 isn’t likely to lower prices in NC’s individual market where costs are among the highest in the nation and could get more expensive for beneficiaries over time.Critics also said AHPs could drive up costs in the individual and small-group markets where people who need comprehensive coverage would be forced to seek insurance. AHPs only really help people who are relatively healthy, and get more expensive over time for older workers more likely to have chronic health conditions.
This is similar to a plan Republicans attempted to enact in 2018 that would have allowed insurers to be exempt from ACA requirements, allowing them to “cherry-pick” healthy enrollees. Critics drew comparisons between this plan and a loophole written by Tennessee legislators that has driven up premiums exponentially in that state.
Read more analysis of S86 here.