How association health plans could undermine the health care law’s markets.

The Trump administration just dropped new regulations to allow more small businesses and self-employed Americans to buy skimpier health insurance that doesn’t comply with the Affordable Care Act’s regulations — part of the White House’s multi-pronged crusade to undermine the health care law.

These new rules would make technical changes to “association health plans” — a fixation for Republican lawmakers seeking alternatives to the ACA — that would allow more companies and self-employed individuals to join them. They would also exempt the associations from some of the law’s core insurance rules, which Republicans blame for increasing insurance premiums.

The bottom line is that Trump, as ordained in an executive order last fall that led to these new regulations, is looking to carve out more exemptions for people to escape the ACA’s marketplaces and regulations. Health experts fear that this will damage the law’s markets, because the businesses and people most likely to seek out association health plans under these rules, and avoid the ACA mandates, are younger and healthier, leaving behind an older, sicker, and costlier ACA market.

“There are going to be lots of ways for them to cherry-pick healthy people,” Tim Jost, a health law professor at Washington and Lee University who is generally supportive of the ACA, told me, “and it’s going to further deteriorate the individual market.”

Under current law, small businesses and self-employed workers that buy insurance through associations are still subjected to the ACA’s rules that, for example, require that health plans cover certain essential health benefits. The health care law included that provision to stop insurers from crafting skimpy plans that attract only healthier people. But Republicans have said those strict regulations drive up the cost of health coverage.

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