11/18/2019

Circuit Court Hears Appeal of AHP Ruling

A ruling is not expected until some time early next year

The D.C. Circuit Court of Appeals heard oral arguments on Nov. 14, 2019 in the Trump administration’s appeal of a lower court ruling that invalidated the Department of Labor’s 2018 rule expanding access to association health plans (AHPs). The administration is appealing a district court decision (rendered on March 28) that sided with attorneys general from 11 states and the District of Columbia and called the DOL’s AHP rule an “end-run” around the Affordable Care Act (ACA).

However, at least 30 other states have taken action to conform to the final AHP rule in some way, including issuing guidance, enacting legislation, or simply approving AHP formation – evidence that a majority of the states think that the DOL acted reasonably in developing and issuing the final AHP regulations.

ASAE and The Coalition to Protect and Promote AHPs filed an amicus brief in June in support of the DOL’s AHP rule. In its brief, the Coalition pointed out that AHPs are subject to – and comply with – the ACA’s coverage requirements, ERISA’s consumer protections, and state regulatory requirements. The Coalition further pointed out that 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.

“Importantly, AHPs are covering all ten of the ACA’s ‘essential health benefits’ (EHBs). AHPs also cover pediatric dental and vision services either through their AHP insurance contract or through a stand-alone product,” the coalition said in a statement. “The bottom line is that AHPs are offering comprehensive and affordable health coverage to employees of small employers and self-employed individuals, and these arrangements are not an ‘end-run’ around any federal or state law, despite recent assertions.”

A ruling from the D.C. Circuit Court is not expected until some time early next year.

This article was provided to OSAE by the Power of A and ASAE's Inroads.