Trump administration proposes end run around Obamacare rules

Small businesses and self-employed Americans would be able to bypass Obamacare's rules to buy less comprehensive health insurance plans under new rules proposed Thursday by the Trump administration.

The regulations, which were posted online for public comment and are not yet final, stem from an executive order that President Donald Trump issued in October. They would allow smaller companies and some individuals in the same industry or region to band together and sell "association health plans," which would no longer have to offer "essential health benefits" required under Obamacare like prescription drugs, mental health or maternity care.

For some Americans, the result could be lower premiums, which would be balanced against a heightened risk that they won't be reimbursed for the cost of various health needs. The proposal suggests that newly expanded associations would have more bargaining power with insurers to negotiate prices as well.

But experts also say the move could raise premiums for companies that continue to offer fuller coverage and whose employees have more expensive needs, since employers with healthier workers would be more attracted to the skimpier association plans. If enough self-employed workers join association plans under the new rules, it could raise premiums on the individual market as well.

"The single biggest item is that (association health plans) will be exempt from essential health benefit requirements," Matthew Fiedler, a fellow at the Brookings Institution's Center for Health Policy, said in an e-mail. "That will allow them to craft plans that are likely to appeal to healthier enrollees, siphoning those enrollees from the ACA-compliant market."

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