Return To Full Article
You can republish this story for free. Click the "Copy HTML" button below. Questions? Get more details.

How The Farm Bill Could Erode Part Of The ACA

Some Republican lawmakers continue to try to work around the federal health law鈥檚 requirements. That strategy can crop up in surprising places. Like the .

Tucked deep in the House version of the massive bill 鈥 amid crop subsidies and food assistance programs 鈥 is a provision that supporters say could help provide farmers with cheaper, but likely less comprehensive, health insurance than plans offered through the Affordable Care Act.

It calls for $65 million in loans and grants administered by the Department of Agriculture to help organizations establish agricultural-related 鈥渁ssociation鈥 type health plans.

But the idea is not without skeptics.

鈥淚 don鈥檛 know that anyone at the Department of Agriculture, with all due respect, knows a darn thing about starting and maintaining a successful insurance company,鈥 said Sabrina Corlette, a professor and project director at the Georgetown University Health Policy Institute.

Association health plans are offered through organizations whose members usually share a professional, employment, trade or other relationship, although the Trump administration is soon to finalize new rules widely expected to broaden eligibility while loosening the rules on benefits these plans must include.

Under that proposal, association plans would not have to offer coverage across 10 broad 鈥渆ssential鈥 categories of care, including hospitalization, prescription drugs and emergency care. They could also spend less premium revenue on medical care.

Under the farm bill, the secretary of Agriculture could grant up to 10 loans of no more than $15 million each, starting next year, to existing associations whose members are ranchers, farmers or other agribusinesses.

The language is strikingly similar to a introduced April 12 by Rep. Jeff Fortenberry (R-Neb.), a supporter of association health plans. He did not respond to calls for comment.

Although the farm bill is usually considered 鈥渕ust-pass鈥 by many lawmakers, it is currently facing pushback because of surrounding other parts of the measure, mainly language that would add additional work requirements to the food stamp program.

Still, the focus on association health plans won鈥檛 go away.

The plans 鈥 coupled with another Trump administration move to make short-term insurance more widely available 鈥 could draw healthier people out of the ACA markets, leaving the pool of beneficiaries with higher percentages of people who need medical care. And that, some say, could drive up premiums for those who remain.

The National Association of Insurance Commissioners, for example, that association plans 鈥渢hreaten the stability of the small group market鈥 and 鈥減rovide inadequate benefits and insufficient protection to consumers.鈥

have made similar arguments.

Others are concerned about the idea of the government providing funding for such plans.

鈥淲e have reams of experience with AHPs that have gone belly up 鈥 and the notion that we should put taxpayer money into them is irresponsible,鈥 said Georgetown University鈥檚 Corlette.

She was referring to the with plans. Some have served members well, but other plans have been marked by solvency problems that left consumers on the hook with unpaid medical bills or were for providing little or no coverage for such things as chemotherapy or doctor office visits.

It鈥檚 not fair to simply focus on the failures, countered attorney Christopher Condeluci, who served as tax and benefits counsel to the Senate Finance Committee and now advises private clients, some of whom are interested in association plans.

鈥淪ome AHPs were not successful,鈥 he agreed. 鈥淏ut there鈥檚 arguably more examples of AHPs that work. The trouble is everyone focuses on the negative.鈥

Although the GOP generally supports association plans, using taxpayer funds to help start them could prove problematic for some conservatives in Congress.

Many Republican lawmakers expressed concerns about the use of tens of millions of taxpayer dollars to start insurance co-ops that were part of the ACA, most of which failed.

鈥淭he hard-earned tax dollars collected from working Americans, sitting at Treasury right now, are not venture capital, said Rep. Kevin Brady (R-Texas) at a subcommittee hearing in November 2015. Currently, Brady is chairman of the powerful House Ways and Means Committee.

The provision could also be popular in rural areas.

鈥淲e think it鈥檚 a good idea,鈥 said Rob Robertson, chief administrator for the Nebraska Farm Bureau Federation, whose group is considering sponsoring one.

About half of his members, Robertson said, have a spouse working a non-farm job, mainly for insurance coverage. Of those who buy their own plan, some are facing astronomical premiums and are looking for relief.

鈥淚 can鈥檛 think of any sector that is affected more by the huge premium increases under Obamacare than farmers and ranchers,鈥 he said.

The farm bill 鈥 including the AHP provision 鈥 was approved by the House Committee on Agriculture in mid-April, and is currently awaiting floor consideration. Meanwhile, a final rule on the Trump AHP rule, which has drawn more than from supporters and opponents, could be issued as early as this summer.

麻豆女优 Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at 麻豆女优鈥攁n independent source of health policy research, polling, and journalism. Learn more about .

Help 麻豆女优 Health News track this article

By including these elements when you republish, you help us:
  • Understand which communities and people we鈥檙e reaching.
  • Measure the impact of our health journalism.
  • Continue providing free, high-quality health news to the public.
Canonical Tag

Include this in your page's <head> section to properly attribute this content.

Tracking Snippet

Add this snippet at the end of your republished article to help us track its reach.