Jan 04, 2018 | By Jack Craver
By allowing self-employed individuals to sign up for group plans made up of other individuals, the Trump administration argues that they will be able to get lower prices. (Photo: AP)
The latest attempt came on Thursday, when the Department of Labor announced a new proposed rule to allow small businesses and self-employed people to band together to purchase insurance plans that are not subject to many of the Obamacare requirements.
Currently, self-employed people, or sole proprietors, can buy plans as individuals through the ACA exchange. By allowing them to sign up for group plans made up of other individuals, the Trump administration argues that they will be able to get lower prices.
The plans will also likely be cheaper because they will be exempt from the ACA requirement that insurance policies cover 10 “essential” benefits, such as maternity care and mental health treatment. Republicans have long argued that people should be able to purchase such “skinny” plans that are tailored more specifically to their individual needs.
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A number of trade groups, including the National Restaurant Association and the National Retail Federation, came out in support of the rule. Businesses in those industries have traditionally had many low-wage employees who they do not provide with insurance.
While Republicans frame the new rule as a way to offer people cheaper alternatives to ACA plans, Democrats view it as a way to undermine the ACA market by allowing the healthiest people to opt out. The new rule, combined with the repeal of the individual mandate that was included in the tax bill passed last month, could result in the ACA marketplace being dominated by older, sicker patients, leading to further premiums increases.
Assuming the new rule goes into effect, however, certain ACA regulations will still apply to the new plans. Plans will not be able to reject or charge customers more based on pre-existing conditions.
Larry Levitt, who heads up health research at the Kaiser Family Foundation, tweeted that the maintaining protections for pre-existing conditions in the new plans will “mitigate the extent to which these plans destabilize the current insurance market.”
However, he added, “I have no doubt that (insurers) would find clever ways of cherry picking healthier people implicitly — e.g., based on what benefits they cover.”
So far, the efforts to undermine the ACA have not succeeded. Despite dramatically cutting spending on the marketing of ACA plans, shortening the enrollment period and repealing the requirement to buy insurance, ACA sign-ups were only slightly lower in the enrollment period that just ended than they were last year, with roughly 8.8 million enrollees.