And fulfills yet another campaign promise.
During the 2016 primary season, Donald Trump pledged to facilitate lower health insurance premiums by permitting coverage to be sold across state lines. Oddly, considering that conservatives have long advocated this as a way of augmenting market competition among insurers, the proposal was ridiculed by his opponents for the Republican presidential nomination. During one debate Marco Rubio actually mimicked Trump’s physical gestures, mocked his references to “lines around the states,” and snidely added, “whatever that means.” Friday, the Trump administration demonstrated what that means by issuing a new regulation allowing association health plans (AHPs) to offer coverage across state lines.
The new regulation, which was published in the Federal Register on January 5, will be available for public comment for 60 days. When it goes into effect, it will allow small employers to band together for the purpose of buying health insurance in the large group market. Specifically, it will “allow employers to form small business health plans based on geography or industry” and permit such plans “to serve employers in a state, city, county or a multi-state metro area.” It can be used to “serve all the businesses in a particular industry nationwide,” and also allows sole proprietors to join small business health plans. The Trump administration, via the U.S. Department of Labor, summarized its intended effect as follows:
These improvements stand to open health insurance coverage for millions of Americans and their families by making it more affordable for thousands of small businesses and sole proprietors. By joining together, employers may reduce administrative costs through economies of scale, strengthen their bargaining position to obtain more favorable deals, enhance their ability to self-insure, and offer a wider array of insurance options.
The impetus for the new AHP rule was provided by Executive Order 13813, “Promoting Healthcare Choice and Competition Across the United States,” issued by President Trump last October. Among the EO’s goals was “to facilitate the purchase of insurance across state lines and the development and operation of a healthcare system that provides high-quality care at affordable prices for the American people.” This seemed pretty reasonable from the proletarian perspective, yet the “news” media responded with apocalyptic rants like this one from the Washington Post: “Trump’s Obamacare order could destroy the health care system.” In this monument to thoughtful journalism, the author issued the following cri de coeur:
President Trump has made a lot of promises on health care. Somehow, though, I don’t remember him promising stadiums of cheering fans that he’d take away protections for preexisting conditions, increase deductibles, spike premiums, eliminate basic coverage requirements and, more generally, destabilize the individual health-insurance market. But that is what he said he’d do Thursday, when he signed an executive order on health care.
This was hysterical nonsense, of course, but EO 13813 and its accompanying regulations are not good news for Obamacare. So, the editors of the Post published a column Friday titled “The Trump administration’s hidden attacks on the Affordable Care Act,” by the Kaiser Foundation’s Larry Levitt. Levitt takes a “more in sorrow than in anger” approach. He even condescends to admit, “The desire to make less expensive insurance available to middle-class consumers who buy their own insurance and are not eligible for ACA subsidies is understandable.” He nonetheless seems more worried about damage the AHP regulation will inflict on Obamacare. In the end, however, he grudgingly allows that it will work as intended: MORE HERE