As explained in this space yesterday, there are several reasons to be deeply concerned about the “Association Health Plans” bill that was sent to Gov. Cooper yesterday after passage by both houses of the General Assembly.
Proponents argue that the proposal is about using market forces to promote more affordable health insurance options, but what the proposal really represents is a return to the disastrous era that existed before the Affordable Care Act became law – a time in which insurers refused to cover essential care items like maternity and newborn care, mental health and substance use disorder treatment, prescription drugs, and other critical services, and were allowed to charge people more based on their age, gender and home address.
Ultimately, such a scheme will drive up costs for people insured in quality plans, expand the coverage gap and assure that more people go bankrupt and/or avoid necessary health care.
Today, one of the nation’s most venerable advocacy groups for promoting healthy pregnancies and births echoed many of those same concerns. This is from a statement from the March of Dimes:
As the oldest organization in the United States advocating for the healthy moms and healthy babies, the March of Dimes urges Governor Roy Cooper to veto SB 86 and to oppose the further creation of association health plans (AHPs) in North Carolina. We ask the Governor to veto this bill and to continue working with March of Dimes and other health organizations on finding a true solution for closing the state’s health insurance coverage gap.
The March of Dimes believes that SB 86 would hinder access to comprehensive health insurance and would weaken the insurance market for all North Carolinians. AHPs are a mechanism to provide health coverage to small businesses and self-employed individuals without having to meet the standards and consumer protections that would otherwise apply to plans sold to small businesses and individuals on the Health Insurance Exchange.
Chief among our concerns is that AHPs can exclude benefits like maternity care and may also set annual and lifetime spending caps for any of the essential health benefits not covered. This type of skimpy coverage could be devastating for a family that has a premature baby or a child born with a birth defect. In instances where these critical benefits are not covered, AHPs do not protect patients by providing for a maximum out of pocket maximum spending limit, so patients are often responsible for paying much more in health care costs than they would in the regular marketplace. Our greatest fear is that these limits could prevent a mother or a baby from getting the treatment they need to live long and happy lives.
The March of Dimes will continue to work with Governor Cooper and the General Assembly to find comprehensive, responsible alternatives for expanding access in our state, but SB 86 and AHPs are bad for patients and bad for North Carolina.