NEWS TODAY: Rules on plans to undercut ACA were released today. Experts are reviewing them. On phone and putting out what I am hearing soon.
Follow here if interested for details.
Follow here if interested for details.
The premise is that these new insurers will not subject to the requirements of the ACA like what must be covered or much state regulation.
These lower cost plans will be more attractive to healthy people, but, when they become sick, what they covered won't be guaranteed. 2/
These lower cost plans will be more attractive to healthy people, but, when they become sick, what they covered won't be guaranteed. 2/
These new plans won't be regulated by HHS but by the Dept of Labor which takes any of the governance away from the experts in health-- purposely.
Labor: one would think that means this is aimed only at employers. The regulation appears to push the boundary... 3/
Labor: one would think that means this is aimed only at employers. The regulation appears to push the boundary... 3/
The regulation aims to push the idea of what can be considered an association.
Someone I talked to today referred to it as being able to create an "air breathers association." Essentially, making it as rude-less as possible. 4/
Someone I talked to today referred to it as being able to create an "air breathers association." Essentially, making it as rude-less as possible. 4/
Many of the premises of AHPs have been shown not to work in the past.
For example, the rule says AHPs will create "increased buying power". Breaking up pools does exactly the opposite.
Instead, a "Runners' Association" just sends a clear signal that these are healthy people. 5/
For example, the rule says AHPs will create "increased buying power". Breaking up pools does exactly the opposite.
Instead, a "Runners' Association" just sends a clear signal that these are healthy people. 5/
Here's what people might call a "funny one": They acknowledge that AHPs will make the ACA "more susceptible to risk selection."
No worries: it goes on to say the individual mandate will limit the negative effect.
Yep, the same individual mandate Congress just repealed.🤔 6/
No worries: it goes on to say the individual mandate will limit the negative effect.
Yep, the same individual mandate Congress just repealed.🤔 6/
There is a lot of energy towards blurring the definition of what an employer is (I guess its not obvious when looking to make new rules) and will be a major source of both comment and potential litigation as it aims to create broader & broader loopholes from ACA coverage. The 7/
Proposal suggests allowing people to make "written representations" of whether they can join an association or be a "common law" employee or a "working owner." They appear to be looking for ways for contractors, sole proprietors & others who are healthy too leave the ACA pool.8/
These plans are not supposed to discriminate against sicker people.
What it means: AHPs have to admit ppl w cancer. But they aren't required to offer chemotherapy. Or...
Sickle cell
HIV
Obesity
Maternity...
This was th norm before the ACA-- lawful, easy way to avoid the sick.9/
What it means: AHPs have to admit ppl w cancer. But they aren't required to offer chemotherapy. Or...
Sickle cell
HIV
Obesity
Maternity...
This was th norm before the ACA-- lawful, easy way to avoid the sick.9/
This brings back the reason why the ACA outlawed all these efforts to avoid the rules: a single risk pool is much better. Argue about how to define the pool, but as soon as you create one w no rules-- the one left behind eventually just becomes sicker & less affordable. 10/
ACTION: The rule is preliminary & there is a 60 day comment period.
Experts and regular folks should weigh in.
When I was at HHS w 44, we thoroughly reviewed every comment & made adjustments. There is much to learn. I hope this Administration makes the same effort./.end
Experts and regular folks should weigh in.
When I was at HHS w 44, we thoroughly reviewed every comment & made adjustments. There is much to learn. I hope this Administration makes the same effort./.end
