In our last column, “Guilt by Association” from July 26, we answered a question about the re-appearance of “association” health plans.
These are commonly called Multiple Employer Trusts and they allow employers in a like industry to pool their employees and act as a private insurance carrier.
The one we had experience with was primarily for Chamber of Commerce members in different areas of the state and it worked well…for a while.
The point of the column was that these types of plans seemed to be making a comeback after being expressly forbidden by the Affordable Care Act (ACA).
Through an executive order last October, the plans were expressly allowed.
But, not so fast! Our Attorney General, Xavier Becerra, joined other state attorneys general in filing a lawsuit in federal court.
The 12 attorneys general are suing the Trump administration in an effort to again restrict association health plans.
The other states in the suit are New York, Massachusetts, Washington, D.C. (I know, not a state), Delaware, Kentucky, Maryland, New Jersey, Oregon, Pennsylvania, Virginia, and Washington.
The central argument against the plans is that employees would get fewer health benefits than required by law.
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The law, ACA/Obamacare, is still in effect and has a mandate that all health plans must include what is called the “Ten Essential Health Benefits.”
The ACA says that these benefits be covered without annual dollar caps, i.e., unlimited.
Here are the categories: outpatient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services; prescription drugs; rehabilitative services; laboratory services; preventive services and chronic disease management; pediatric dental and vision.
Since association plans can tailor their health coverage plans how they want to, and since proponents of the ACA describe the 10 essential benefits as part of a consumer protection package, Becerra said association plans would lead to employers offering “junk plans.”
Speaking of “junk,” here’s a statement from California State Senate Health Committee Chairman Ed Hernandez regarding the short-term health plans that are available online, but do not comply with ACA guidelines:
“These policies are junk insurance. They are confusing, misleading, barely cover any services, and give people a false sense of coverage. The Trump Administration continues to compromise our health care and destabilize California’s insurance market, but I won’t stand for it. SB 910 is desperately needed. Prohibiting junk insurance in California will ensure that we don’t go back to the days before the ACA when patients could go into debt from their care or be denied coverage completely.”
Anthony Wright, of Health Access California, said his coalition of labor, consumers and other advocacy groups support banning short-term plans, expanding state coverage to include more undocumented immigrants and having a state-only individual mandate.
There is still a lot of interest in a California single-payer plan.
Meanwhile, the federal Health and Human Services department has recently approved allowing short-term health insurance to go from 90 days to 364 days.