After launching a new health insurance plan for its members in November, the Missouri Chamber of Commerce and Industry said Wednesday it has no initial plans to create a type of health care plan authorized Tuesday by President Donald Trump.
The White House released final rules Tuesday governing association health plans, which make it easier for small businesses to band together and buy health insurance based on their industry or location. Business groups nationwide hope the move could allow small businesses to offer cheaper alternatives to plans mandated by the Affordable Care Act.
The rule allows association health plans to be regulated in the same ways as large employer policies, which would exempt them from many ACA rules. Association plans also allow groups to base employers' rates on gender, age and industry of its workers.
The Missouri Chamber began offering similar plans called multiple-employee welfare arrangements to its members and other chambers of commerce across the state in November. MEWAs, as they're known, allow businesses with two to 50 employees to offer health insurance to employees as an alternative to the ACA.
Brendan Cossette, Missouri Chamber of Commerce and Industry chief operating officer, said like association plans, MEWAs allow small employers to band together, are self-funded and are not required to adhere to all ACA regulations.
"We were pretty forward thinking in getting out ahead of the president on this," Cossette said. "Unlike what's probably going to happen with most of the association plans, we are choosing to offer all of the benefits that are mandated under the ACA."
President Trump telegraphed the new rules in October when he signed an executive order that promised millions of Americans could obtain inexpensive plans as alternatives to plans on ACA exchanges. National business groups like the National Retail Federation and the National Restaurant Association welcomed the new rules Tuesday.
"This is an important step toward expanding affordable health care options for small businesses and lowering costs for their employees," said David French, National Retail Federation senior vice president for government relations, in a news release. "We will carefully review the final rules to help make association health plans a reality for small retailers nationwide."
Association plans will likely cost less than traditional plans offered by employers or than plans offered on ACA exchanges. They will also likely have fewer benefits, which could leave sick and older workers without access to the plans.
Consumer groups also worry association plans could siphon off young and healthy workers and leave pools of old and sick Americans on ACA exchanges. Cossette said association plans will likely be tailored to what each entity wants.
"Due to the fact that they're not subject to all the requirements of the ACA and the benefits provided, a lot of the plans may be quite thin," he said. "So a lot of them will likely be less robust as many of the plans now available under the ACA."
The new rules also may allow companies to fulfill a Trump campaign promise to sell insurance across state lines. Right now, most health insurance laws are governed by state regulations. Under the new rules, state regulators will maintain oversight of the policies, but bands of employers or groups from different states could form a group covered by the rule.
Cossette said this could be a sticking point for groups that pursue association plans in the future.
"Complying with a bunch of different states is a difficult thing," he said. "An association plan fully within a state is quite viable."
Under its MEWA, the Missouri Chamber offers plans to about 5,000 people in "a few hundred" groups. The Jefferson City Area Chamber of Commerce began offering health insurance under the Missouri Chamber's MEWA to its members in February.
The Missouri Chamber offers plans to its 23 employees under its MEWA. Cossette said in three years before the Missouri Chamber began offering plans under its MEWA, the price of health insurance premiums for the group increased 100 percent.
Under the MEWA, premiums of the Missouri Chamber's employees decreased 20 percent.
"It has been helpful for us," Cossette said. "