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Federal Judge Rules Against Expansion of Inadequate Association Health Plans

March 29, 2019

Washington, D.C.—A federal judge has blocked a rule change that would have expanded the availability of Association Health Plans (AHP). These plans often leave beneficiaries underinsured because they are exempt from covering the essential health benefits required under the health care law, including prescription drug coverage, and can also cap coverage based on the number of hospital days or cost of services and cover less than 60 percent of a patient’s medical costs. Although this makes the plans less expensive and more attractive to younger and healthier enrollees, it in turn leaves them at risk for inadequate coverage while potentially forcing older and sicker patients who need more comprehensive coverage to pay ever-increasing premiums for their insurance.

A statement on the court decision from Lisa Lacasse, President of the American Cancer Society Cancer Action Network (ACS CAN), follows:

“The federal court ruling protects patients from the proliferation of these inadequate health care plans. Allowing plans to skimp on essential health benefits exposes individuals to significant out-of-pocket costs for uncovered care. The result would have been financially devastating for those with serious conditions, like cancer, who’d likely have paid more and more for the kind of comprehensive care they absolutely need. The plans are similarly problematic for healthy individuals who wind up underinsured should they face serious illness or injury.

“We’re pleased the court has stepped in and prevented this damaging policy from going into effect and urge Congress and the administration to take this as an opportunity to work together in a bipartisan way to strengthen our nation’s health care system.”

Media Contacts

Allison Miller
Director, Media Advocacy
Washington, D.C.
Alissa Crispino
Vice President, Media Advocacy & Communications
Washington, D.C.