On October 12, 2017, President Trump signed an executive order modifying the Patient Protection and Affordable Care Act (“PPACA”), which the administration deemed as having limited the choice of healthcare options and produced an increase in premiums.
The Trump administration intends to prioritize three areas for improvement: association health plans (“AHPs”), short-term, limitedduration insurance (“STLDI”), and health reimbursement arrangements (“HRAs”). The order states expanding access to AHPs will assist small businesses to group together to self-insure or purchase large group health insurance and avoid certain costly requirements in the PPACA. STLDIs will be exempt from certain insurance mandates and regulations in the PPACA which is intended to make it available as an alternative to government-run exchanges. HRAs will also be expanded and employees will purportedly receive more flexibility with how to use them.
AHP: Within sixty days of the order, the Secretary of Labor will consider proposing regulations or revising guidance to allow more employers to form AHPs. The Secretary will consider expanding conditions that satisfy the commonality-of-interest requirements under the current Department of Labor advisory opinions interpreting the definition of an “employer” under the Employee Retirement Income Security Act (“ERISA”).
STLDI: Within sixty days of the order, the Secretaries of Treasury, Labor, and Health and Human Services will consider proposing regulations or revising guidance to expand availability of STLDI. The Secretaries are to consider allowing such insurance to cover longer periods and be renewed by the consumer.
HRA: Within 120 days of the order, the Secretaries of the Treasury, Labor, and Health and Human Services will consider proposing regulations or revising guidance to increase the usability of HRAs, to expand employers’ ability to offer HRAs to employees, and to allow HRAs to be used in conjunction with nongroup coverage.