WASHINGTON – On behalf of small businesses and self-employed individuals across the country, we applaud Representatives Walberg (R-MI), Foxx (R-NC), Burgess (R-TX), and Allen (R-GA), along with Senators Kennedy (R-LA), Rubio (R-FL), Sasse (R-NE), Braun (R-IN), Scott (R-FL), and Hyde-Smith (R-MS), for their ongoing commitment to enacting policies that would give employees of small employers and self-employed individuals with no employees much-needed access to comprehensive, affordable health coverage through an “Association Health Plan” (AHP).
For the past three years, the Coalition to Protect and Promote Association Health Plans has worked tirelessly to correct-the-record about AHPs. Contrary to what critics are saying, AHPs are not an “end-run around” the Affordable Care Act (ACA). Quite the opposite. AHPs have offered – and will continue to offer – health coverage that is just as comprehensive, and in some cases more comprehensive, than ACA-compliant “small group” and “individual” market plans.
Importantly, AHPs are voluntarily covering all ten of the ACA’s “essential health benefits” (EHBs), including pediatric health services. AHPs also cover pediatric dental and vision services either through their AHP insurance contract or through a stand-alone product.
In addition, AHPs offer broader “health care provider networks” relative to many existing ACA small group and individual market plans, and they are priced at an “actuarially fair premium” for both young and old AHP participants. Doing so encourages more young and healthy individuals to enroll in AHP health coverage, which in turn benefits older and less healthy AHP participants by increasing the size of, and balancing out, the risk pool.
AHPs are also subject to specific rules that prevent them from discriminating against individuals/employees based on a health condition. Most importantly, AHPs are prohibited from denying people coverage if they have a pre-existing condition.
It is important to emphasize that at least 30 States have signaled that they want to allow AHPs to cover (1) small employers in different industries and (2) self-employed individuals with no employees. These States already allow AHPs to cover small employers in the same industry.
This is compared to the 11 States and the District of Columbia that have filed a lawsuit to invalidate the Department of Labor’s final AHP regulations (issued on June 21, 2018) that would have allowed AHPs to cover (1) small employers in different industries and (2) self-employed individuals with no employees. These 11 States and DC already prohibit AHPs that cover small employers in the same industry.
Our Coalition is eager to work with Congress, the Biden Administration, and State insurance regulators to build on this legislation so together, we can provide small employers and self-employed individuals with as many health care options as possible; provided these health care options offer comprehensive health coverage and protect people with pre-existing conditions. We are all trying to solve for the same problem, and our Coalition is ready, willing, and able to roll-up our sleeves to develop the right set of coverage and premium rating requirements to ensure that AHPs protect patients while offering quality and affordable coverage.
Quotes from Our Coalition Members
“Association Health Plans (AHPs) voluntarily cover the ACA’s essential health benefits, and they develop premiums for older and younger AHP participants that are better aligned with claim costs, which more effectively balances out the risk pool. Talking points to the contrary mis-represent the commitment our association members have to their small employer and self-employed individual members. Our member-associations want to offer comprehensive health coverage to their respective members, and they are not in the business of offering sub-standard health plans. AHPs achieve the policy goal that both political parties want – access to quality, comprehensive, and affordable coverage.”
– Susan Robertson, CAE, President and CEO, American Society of Association Executives
“The AVMA is a strong supporter and advocate of a national framework for Association Health Plans (AHPs). Providing this option is important to veterinary small businesses to allow them to band together to obtain affordable, high-quality healthcare options for their employees. On behalf of the veterinary profession, we will work with Congress and other stakeholders to expand the availability of Association Health Plans to ensure veterinarians and their teams receive the coverage they deserve.”
– Dr. Douglas Kratt, President, American Veterinary Medical Association
“The skyrocketing cost of health insurance continues to be a top concern for our members. Employers purchasing health insurance on the small group market are at a competitive disadvantage since they lack the bargaining power of large employers. Our members want to provide comprehensive coverage they can also afford to help attract and retain employees. Association Health Plans would provide an alternative solution to help small business attract employees and ultimately achieve a shared goal to provide for more lives with comprehensive health insurance coverage.”
– John Krahe, President & CEO, Manufacturer & Business Association
“Association Health Plans often offer more comprehensive coverage at lower costs than traditional individual plans, and the flexibility they afford to independent contractors is invaluable. As NAR continues our work to secure more favorable health insurance solutions for America’s 1.4 million Realtors® and their families, we are grateful that Representatives Walberg and Foxx are taking concrete steps to improve America’s broader healthcare system.”
– Charlie Oppler, 2021 President, National Association of REALTORS®
“Nine in 10 restaurants are small businesses, who often struggle with the increasing cost of healthcare. Association Health Plans offer small businesses and their employees the opportunity to obtain comprehensive, quality healthcare which is commonly available to larger companies.”
– Aaron Frazier, Director of Healthcare and Tax Policy, National Restaurant Association
“Small business owners compete for their employees with large businesses everyday and what they need in order to compete is access to affordable, high quality employee benefit plans. Association Health Plans (AHPs) help level the playing field between small and large firms by increasing the number of health insurance choices in the marketplace. When managed correctly, AHPs are incented to negotiate the best product and price for their members with the health insurance carrier on premium rates, coverage choices, networks, etc.”
– Scott Lyon, Senior Vice President, Small Business Association of Michigan
About The Coalition to Protect and Promote Association Health Plans
The Coalition is currently comprised of like-minded organizations that believe employees of small employers and self-employed individuals deserve quality coverage with strong consumer protections. Member organizations include the: American Composites Manufacturers Association; American Farm Bureau Federation; American Society of Association Executives; American Society of Travel Advisors; American Veterinary Medical Association; Associated Employers Benefit & Trust; Association of Web-Based Health Insurance Brokers; Decisely Insurance Services; Food Marketing Institute; Foundation for Government Accountability; Global Cold Chain Alliance; Indiana Credit Union League; International Sign Association; Manufacturer & Business Association; Marsh McLennan; McDonald’s Licensees Health & Welfare Trust; Mercer; Michigan Business and Professional Association; Michigan Dental Association; National Association of Mortgage Brokers; National Association of REALTORS®; NFIB; Small Business Association of Michigan; TranscendAHP; and Vimly Benefit Solutions.