Trump Proposes New Health Plan Options for Small Businesses

Trump Proposes New Health Plan Options for Small Businesses

When he signed the executive order in October calling for the new rules, President Trump said they would provide millions of Americans with relief from “the disaster of Obamacare.” Credit Doug Mills/The New York Times

WASHINGTON — The Trump administration on Thursday proposed sweeping new rules that could make it easier for small businesses to band together and create health insurance plans that would be exempt from many of the consumer protections mandated by the Affordable Care Act.

As many as 11 million Americans “could find coverage under this proposal,” the Labor Department said in issuing the proposed rules, which carry out an executive order signed by President Trump on Oct. 12. The public will have 60 days to comment on the proposal before the Trump administration adopts final rules with the force of law.

The proposal would allow small business owners, their employees, sole proprietors and other self-employed people to join together as a single group to buy insurance in the large-group market. The new health plans could be exempt from some requirements of the Affordable Care Act. They would, for example, not have to provide certain “essential health benefits” like mental health care, emergency services, maternity and newborn care and prescription drugs.

“By joining together,” the Labor Department said, “employers may reduce administrative costs through economies of scale, strengthen their bargaining position to obtain more favorable deals, enhance their ability to self-insure and offer a wider array of insurance options.”

But consumer groups, state officials and Blue Cross and Blue Shield plans have strenuously opposed similar ideas for years. Association health plans, they say, will tend to attract employers with younger, healthier workers, leaving behind sicker people in more comprehensive, more expensive plans that fully comply with the Affordable Care Act. That could drive up premiums, which already have risen steadily as Republicans have taken aim at President Barack Obama’s signature domestic achievement.

“Those with serious health conditions like cancer would be left paying ever-increasing premiums for comprehensive coverage,” said Chris Hansen, the president of the American Cancer Society Cancer Action Network. “The rule proposed today will almost certainly result in more people facing financial distress when an unexpected health crisis happens.”

Similar health plans have a history of fraud and abuse that have left employers and employees with hundreds of millions of dollars in unpaid medical bills.

Marc I. Machiz, who investigated insurance fraud as a Labor Department lawyer for more than 20 years, said the proposed rules were an invitation to more scams.

“Any idiot with a word processor can create an association in 10 minutes and market it to small employers and individuals who certify that they are self-employed,” Mr. Machiz said. “The employers and individuals will pay premiums. By the time they discover they’ve been sold a fraudulent product, the promoter will be on his way to the Caribbean.”

But two influential trade groups that could potentially sponsor the new health plans, the National Restaurant Association and the National Retail Federation, welcomed the proposed rules.

The proposal deals another blow to the Affordable Care Act just two weeks after Mr. Trump signed tax legislation that will eliminate penalties for people who go without health insurance.

Republicans in Congress have been trying for two decades to promote association health plans through legislation. The House passed a bill that included such plans in 1998, but it died in the Senate. President George W. Bush proposed them in 2003 and 2004. The House passed a bill to encourage them last March. And Senator Rand Paul, Republican of Kentucky, has championed a similar bill in the Senate.

Now the Trump administration says it will use its regulatory authority to accomplish what Congress could not.

The proposal offers a new interpretation of “employer” and other terms in the Employee Retirement Income Security Act of 1974, the framework for employer-sponsored health plans covering tens of millions of Americans.

Mr. Trump had ordered the Labor Department to develop the rules as a way to provide insurance options for consumers and small businesses that he said would cost less because they would be “exempt from the onerous and expensive insurance mandates” in the 2010 health law.

Mr. Paul praised the rules, saying they would “allow more Americans to join in groups to purchase lower-cost health insurance across state lines.”

In response to critics, the Trump administration said that its proposal included some protections for consumers: “Small business health plans (association health plans) cannot charge individuals higher premiums based on health factors or refuse to admit employees to a plan because of health factors,” such as a physical or mental illness, disability, claims history or genetic information.

The rules would expand the types of groups that could form association health plans and would allow for membership across state lines. Employers around the country could, for example, band together if they were in “the same trade, industry, line of business or profession” but had no other connections to one another. Likewise, employers in the same state, region or metropolitan area could form a group health plan.

For many years, the department has required a much greater “commonality of interest” among small businesses that wanted to be treated as a large group when buying insurance.

To qualify under current rules, small businesses generally must have some purpose and relationship “unrelated to the provision of benefits.”

William G. Schiffbauer, a lawyer who specializes in insurance and employee benefits, said Thursday that the rules would “overturn years of advisory opinions from the Labor Department.” If the agency adopts this proposal as a final rule, he said, “it will very likely be challenged in the federal courts, delaying implementation” and shifting attention back to Congress.

The department said its new interpretation of the 1974 law, known as Erisa, was justified by “the need to expand access to health care” and respond to “changing market dynamics.”

The rules would make new insurance options available to “the millions of uninsured Americans who are sole proprietors or the family of sole proprietors,” the department said.

When he signed the executive order in October, Mr. Trump said the rules would provide millions of Americans with relief from “the disaster of Obamacare.”

In addition, the Labor Department said Thursday, association health plans could give small businesses relief from some state insurance rules that restrict “product offerings and pricing.”

Under the rules, association health plans could buy commercial insurance or serve as their own insurers, paying claims directly from the plan’s assets. Some people who now obtain coverage in the Affordable Care Act marketplace could instead join association health plans.

In an interview last week with The New York Times, Mr. Trump suggested that the new policy had been put into effect, but that is not the case.

“We’ve created associations, millions of people are joining associations,” he said in the interview. “Millions. That were formerly in Obamacare or didn’t have insurance. Or didn’t have health care. Millions of people.”

The department acknowledged that association health plans had a history of financial mismanagement and abuse. Some plans, it said, “have failed to pay promised health benefits to sick and injured workers while diverting, to the pockets of fraudsters, employer and employee contributions from their intended purpose of funding benefits.”

The department said it now had the authority to prevent such abuses. But former employees said the department’s enforcement apparatus had been weakened by budget cuts and could not adequately police compliance.

President Trump restores faith in businesses with deregulation

President Trump restores faith in businesses with deregulation

The Trump Effect: Business, Anticipating Less Regulation, Loosens Purse Strings
New York Times
Binyamin Appelbaum & Jim Tankersley
January 1, 2018

“A wave of optimism has swept over American business leaders, and it is beginning to translate into the sort of investment in new plants, equipment and factory upgrades that bolsters economic growth, spurs job creation — and may finally raise wages significantly.

“While business leaders are eager for the tax cuts that take effect this year, the newfound confidence was initially inspired by the Trump administration’s regulatory pullback, not so much because deregulation is saving companies money but because the administration has instilled a faith in business executives that new regulations are not coming.

“…And with tax cuts coming and a generally improving economic outlook, both domestically and internationally, economists are revising growth forecasts upward for last year and this year.

“Even before it became clear that Republicans would pass a major tax cut, capital spending had risen significantly, climbing at an annualized rate of 6.2 percent during the first three quarters of last year. Surveys of planned spending also show increases.

“Mr. Trump bragged in a news conference last month that he has rolled back 22 regulations for every new one — 67 deregulatory actions, versus three new regulations. Often in conjunction with the Republican Congress, his administration has canceled several rules approved at the end of the President Barack Obama’s term, including a regulation on limiting mining debris in streams, a requirement that broadband providers obtain permission from customers to collect and use online information, and a ban on plastic bottles in national parks.

“Administration officials said last month that, since January 2017, federal agencies have delayed, withdrawn or made inactive nearly 1,600 planned regulatory actions. Further rollbacks will affect financial services as well as energy and labor rules, among others.

“Businesses acknowledge that the most important reason for their increased optimism is the simple fact that the domestic economy continues to expand, with few clouds on the horizon.

“Better yet, the world’s major economies all are growing for the first time since the financial crisis. Confidence among European manufacturers hit a high in more than a decade, according to European Commission data that goes back to 1985, even without tax cuts or less regulation.

“The low unemployment in the United States may also be prompting increased spending, just as it did in the 1990s, as corporations invest in technology to make workers more productive, or replace them entirely…

“But business executives say the Trump administration deserves credit. Mr. MacDonald said home builders have benefited from the killing of regulations written by the Obama administration, including a rule that broadened the definition of wetlands, which could have restricted home building in certain areas. The National Labor Relations Board also reversed a decision that made builders more responsible for the working conditions of their contractors’ employees.

“In some industries, the administration’s actions will allow companies to engage in activities they might not have been able to otherwise; electric utilities, for example, might be able to invest in upgrading power plants that run on fossil fuels, thanks to a promised rollback of Mr. Obama’s Clean Power Plan to fight climate change.

“The Business Roundtable, a corporate lobbying group in Washington, reported last month that ‘regulatory costs’ were no longer the top concern of American executives, for the first time in six years. Mr. Zandi said that regulation was still the top concern in Moody’s survey of business confidence, but that it was rapidly losing ground to concerns about the availability of labor.

“The National Association of Manufacturers’ fourth-quarter member survey found that fewer than half of manufacturers cited an ‘unfavorable business climate’ — including regulations and taxes — as a challenge to their business, down from nearly three-quarters a year ago.

“Some industries have seen particularly clear changes in fortune. The Trump administration has reversed a number of environmental protections that would have imposed significant costs on energy companies. Mr. Trump’s appointees to the Federal Communications Commission voted last month to repeal so-called net neutrality rules, which treated internet services as a regulated industry, like power lines, and prohibited broadband providers from charging for faster internet service or from blocking or slowing some websites.

“That decision helped prompt Comcast to announce that it would invest more than $50 billion in infrastructure over the next five years.

“The banking industry, in particular, has been buoyed by a relaxed approach to financial regulation as the Trump administration moves to ease many of the postcrisis rules put in place to prevent another financial meltdown. The Treasury Department has issued a series of reports calling for sweeping changes to rules required under the 2010 Dodd-Frank law, and a council set up to designate firms that pose risks to the financial system is in the process of removing those companies from heightened federal oversight.

“Mr. Trump has also installed individuals who have publicly questioned the need for many of the postcrisis rules in major policy roles, including at the Federal Reserve and the Consumer Financial Protection Bureau. Bank stocks have been on a winning streak and ended 2017 up more than 15 percent, according to the KBW Nasdaq Bank Index.

“The confidence is translating to industries that have not, as of yet, seen any obvious benefit or policy changes.

“‘We have spent the past dozen years or longer operating in environments that have had an increasing regulatory burden,’ said Michael S. Burke, the chairman and chief executive of Aecom, a Los Angeles-based multinational consulting firm that specializes in infrastructure projects. ‘That burden has slowed down economic growth, it’s slowed down investment in infrastructure. And what we’ve seen over the last year is a big deregulatory environment.'”

Boom: 40 companies give Trump tax reform bonuses, up to $2,000

Boom: 40 companies give Trump tax reform bonuses, up to $2,000

by Paul Bedard ~ Washington Examiner

Some 40 U.S. companies have responded to President Trump’s tax cut and reform victory in Congress last year by handing out bonuses up to $2,000, increases in 401k matches and spending on charity, a much higher number than previously known.

According to the list from Americans for Tax Reform, “Thanks to tax cuts, growing list of companies announcing bonuses, wage hikes, charitable donations.”

ATR’s John Kartch pulled the list together, and is seeking more.

Only two media companies made the list, Sinclair and MSNBC/Comcast.

Some highlights:

  • Aflac – increase 401(k) match from 50% to 100% on the first 4% of compensation plus one-time $500 contribution to every employee’s 401(k); $250 million increase in overall U.S. investment.
  • BB&T – $1,200 bonuses for 27,000 employees; base wage will rise from $12 to $15 per hour; $100 million in charitable donations.
  • Comcast — $1,000 bonuses to 100,000 employees; at least $50 billion investment in infrastructure in next five years.
  • Express Employment Professionals — $2,000 bonuses to more than 200 non-executive employees.
  • Gate City Bank — $1,000 hand-delivered bonus checks to 538 non-management personnel; $500,000 higher charitable giving; $500,000 worth of free home appraisals.
  • Navient – 98% of Navient’s 6,700 employees will receive a $1,000 bonus (approx. 6,566 bonus-eligible employees).
  • Regions Financial Corporation – base wage increase to $15 per hour; $40 million in charitable donations; $100 million in capital expenditures.
  • Southwest Airlines — $1,000 bonuses for all 55,000 employees; $5 million additional charitable donations.
  • U.S. Bancorp – $1,000 bonuses for 60,000 employees; base wage hike to $15 per hour; $150 million charitable contribution.

Paul Bedard, the Washington Examiner’s “Washington Secrets” columnist, can be contacted at

Women’s History Month Highlight: Dr. Ada Fisher

Women’s History Month Highlight: Dr. Ada Fisher

From her experience in medicine to politics, Dr. Ada M. Fisher has excelled at breaking barriers.

Born in Durham, North Carolina and now residing in Salisbury, Dr. Fisher earned her first degree in biology at the University of North Carolina. She went on to earn her medical degree from the University of Wisconsin at Madison and her Master’s Degree in Public Health from the Johns Hopkins University School of Hygiene and Public Health.

After countless contributions to the medical field as a physician, medical director of Amoco Oil Company, and Service Line Director for the U.S. Department of Veterans Affairs (VA) Occupational Health Services, Dr. Fisher decided to get involved politics.

Dr. Fisher has always been deeply involved with the Republican Party, including her work on behalf of the George W. Bush, John McCain, Mitt Romney, and Donald J. Trump campaigns.

In addition, she has served as the RNC’s Committeewoman for North Carolina the last nine years.

As a part of the RNC’s celebration of Women’s History Month, we asked Dr. Fisher to share some of her experiences as a Republican woman.


What does being an African American woman in the Republican Party mean to you?

Being an African American woman in the Republican Party means much more than being a face. It means I am going to need to be the one to advocate for women’s issues and for those who often go overlooked.

The Republican Party is the last bastion of hope for democracy and the Constitution in this nation, which is progressively racing towards a brand of socialism where people are more concerned with expanding entitlement programs and not explaining how we will fund it.

When you initially became involved in politics, what was your primary goal?

I have been a Republican for over 50 years.  Initially, I got active with the Republican Party in 1996 when I moved back to North Carolina because I felt the Party had lost its calling and its mission was more social activism, not what is in the Constitution.  I wanted to help the GOP find solutions that work.  This led to my codifying concepts in my book Common Sense Conservative Prescriptions Solutions for What Ails Us.

What advice would you give to women, particularly African American women, who want to become involved in the Republican Party?

First, you have to demonstrate how the Party’s interests are intertwined with who we are.  This is why I’ve done through my brochures, booklets and other educational materials to let people of color understand that this is their Republican Party and we are not interlopers.

Second, we have to address issues that people care about in a constitutional and Republican manner. When discussing jobs we have to be mindful of what type, who is in line to get them, as well as the type of future that they have. Social services and entitlement programs – though they may seem desirable – are not defined in the Constitution as a responsibility of the federal government.

Third, the Party must continue our ongoing efforts to train and recruit grassroots activists and candidates who look more like America, and provide them the resources they need to win.  We need leaders who rise up from the people, not those who are chosen by the establishment and struggle for relevance.

Fourth, we need to have fun and act like we are enjoying life.  We should be offering solutions that will make a difference.

If we tell our stories, share our accomplishments and live our principles we will draw people to the party. If we include in our policy making those affected by them, they will better reflect the right of center nature of our nation.  If we continue to be mostly talk with no actions, we will turn folks off.

What are some of your passions or hobbies outside of your role at the RNC?

I love to write and tell stories based on my life, my experiences with family and friends, as well as politics.  As a Jewish American, I enjoy what has been too infrequent, time in the Temple.

During my time practicing medicine, I treated and supervised the care for over 100,000 patients.  While I haven’t seen it all, I know our country can do better in delivering quality health care for Americans and especially our veterans.

What has been your proudest accomplishment both personally and professionally?

Completing medical school and surviving the racism of educational institutions while maintaining the ability to think for myself has been most important to me.  I served as the Medical Director for Amoco Oil which was an invaluable learning opportunity.  I also helped draft the Occupational Health Services Standards of Care for corporate America and the Veterans Affairs health system. Keeping America’s Historically Black Colleges and Universities (HBCUs) on the front burner continues to be an important passion.

Helping the Victims of Hurricane Harvey

Helping the Victims of Hurricane Harvey


Our fellow Americans need our help.

Far too many people have been left without food, water, shelter, or power. This is our moment to extend our hearts to the victims of this tragedy and to the silent heroes risking their lives to save others.

Below is a list of suggested charities President Trump emailed to our supporters earlier today. I’d now like to echo his call to help our fellow Americans by donating to one of these charities.

Let’s show the world the true compassion of the American people.

Please keep everyone affected by this tragedy in your thoughts and prayers.

Thank you and God bless America.