Patient groups applaud the Department of Labor’s newly proposed rule strengthening consumer protections in association health plans (AHPs), a health benefit plan sponsored by an employer-based association. Together, they issue the following statement:
The Department proposes to rescind the 2018 rule change that eliminated or substantially altered standards and regulatory structures that protect patients and consumers and that our organizations opposed. AHPs have historically proven risky for enrollees — sometimes leaving patients with thousands of dollars in medical debt. Some of these entities have a long history of fraud and other dubious practices and, according to state insurance regulators, "have been notoriously prone to insolvencies."
In addition to having a history of financial mismanagement, AHPs are not required to cover services included in the essential health benefits (EHB) package. They are permitted to charge higher premiums based on occupation, and in some situations, health status. They can also siphon away healthy individuals from ACA-compliant individual and small-group coverage, leading to higher premiums and fewer plan choices for the people who depend on those markets to access comprehensive coverage.
Our organizations look forward to reviewing this proposed rule carefully and commenting.