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Proposed Rule on HRAs fulfills promise of President’s Executive Order Promoting Healthcare Choice and Competition
On October 12, 2017, the Trump Administration released the President’s Executive Order Promoting Healthcare Choice and Competition, also known as Executive Order No. 13813. On October 29, 2018, the final piece of his instruction to the Secretaries of Labor, Treasury, and Health and Human Services, came in a Proposed Rule to expand the availability and utility of Health Reimbursement Plans (HRAs).
Core Documents, the Trusted Source in affordable plan documents since 1997, has anticipated the roll-back of the Affordable Care Act (ACA) restrictions on HRAs since the Executive Order was first announced. With the release of the Proposed Rule, it is all but certain that the promised relief is coming soon.
Proposed Rule fulfills promise of Executive Order 13813 through Integrated and Excepted Benefit HRAs.
Agencies respond to Executive Order
In EO 13813, President Trump ordered three areas of action under these sections of the document. Here are the sections with the Administration’s and Secretaries’ response to each:
Section 2 – Expanded Access to Association Health Plans (AHP) – instructs the Secretary of Labor to “consider expanding the conditions that satisfy the commonality‑of-interest requirements” as well as “ways to promote AHP formation on the basis of common geography or industry.”
On June 19, 2018, the Trump administration released its final rule governing association health plans, which allow small businesses and the self-employed to band together based on their industry or location and buy health insurance.
Section 3 – Expanded Availability of Short-Term, Limited‑Duration Insurance – directs the Secretaries of Labor, Treasury, and Health and Human Services (HHS), to “consider proposing regulations or revising guidance . . . to expand the availability of STLDI” and “consider allowing such insurance to cover longer periods and be renewed by the consumer.”
On August 2, 2018, the Trump Administration issued a final rule clearing the way for the sale of “short-term, limited-duration insurance” (STLDI), giving millions of people expanded access to health insurance coverage that meets their circumstances and budget.
Section 4 – Expanded Availability and Permitted Use of Health Reimbursement Arrangements – tells the Secretaries of Labor, Treasury, and HHS to propose regulations and to revise guidelines “to increase the usability of HRAs, to expand employers’ ability to offer HRAs to their employees, and to allow HRAs to be used in conjunction with nongroup coverage.”
On October 29, 2018, the Secretaries release a Proposed Rule on Health Reimbursement Arrangements and Other Account-Based Group Health Plans. If accepted, the rules will fulfill Section 4, including the roll-back of ACA mandates by allowing employers offering an HRA to reimburse employees for premiums they pay for individual health coverage. If finalized in its current form, changes will go into effect in January 2020.
The fulfillment of directives set out in President Trump’s EO 13813 brings needed relief to employers and employees across the country. It comes through returning choice and competition to the health insurance market, as the title of the EO says. Promises made, promises kept.