Or­der draws mixed re­ac­tion in Ga.

Some hail it as needed ACA re­lief, while oth­ers are more cau­tious.

The Atlanta Journal-Constitution - - FRONT PAGE - By Ta­mar Haller­man ta­mar.haller­man@ajc.com

WASH­ING­TON — Pres­i­dent Don­ald Trump’s move to loosen some of the fed­eral rules gov­ern­ing so-called associated health plans and short-term in­sur­ance on Thurs­day gar­nered mixed re­ac­tion in Ge­or­gia.

Repub­li­cans lauded the changes for in­creas­ing flex­i­bil­ity and com­pe­ti­tion and pro­vid­ing more lower-cost op­tions to lo­cals with few or no al­ter­na­tives to Obamacare. Democrats and some health groups, mean­while, warned it would un­der­mine the Af­ford­able Care Act by lur­ing away young and healthy peo­ple while rais­ing in­sur­ance pre­mi­ums on the older, sicker Amer­i­cans the law was de­signed to pro­tect.

The changes came in the form of an ex­ec­u­tive or­der, which the pres­i­dent signed Thurs­day morn­ing in the White House’s Roo­sevelt Room, sur­rounded by Cab­i­net of­fi­cials, law­mak­ers and health care and busi­ness ex­ec­u­tives.

“This will cost the United States gov­ern­ment vir­tu­ally noth­ing, and peo­ple will have great, great health care,” Trump said.

The ex­ec­u­tive or­der di­rects fed­eral agen­cies to make three ma­jor changes to health care rules:

■ Ex­pand ac­cess to as­so­ci­a­tion health plans, which al­low small busi­nesses in the same field na­tion­wide (such as elec­tri­cians) to band to­gether to buy in­sur­ance cov­er­age at bet­ter prices, even if the plans are of­fered in an­other state.

■ Widen the win­dow for short­term in­sur­ance cov­er­age from its

cur­rent three-month limit. Such plans tend to be bare­bones and have high de­ductibles. They aren’t sub­ject to many Obamacare man­dates and cov­er­age re­quire­ments, in­clud­ing for pre­scrip­tion drugs and men­tal health ben­e­fits, which makes them cheaper. They’re of­ten re­lied upon by peo­ple be­tween jobs or with few other health care cov­er­age op­tions.

■ Pro­vide in­cen­tives for the use of Health Re­im­burse­ment Ar­range­ments. HRAs are em­ployer-funded ac­counts that are used to re­im­burse em­ploy­ees for out-of-pocket health care costs and pre­mi­ums.

The moves won early praise from Repub­li­cans in Ge­or­gia, in­clud­ing Johnny Isak­son. The third-term U.S. sen­a­tor has been a long­time backer of as­so­ci­a­tion health plans, and he said Trump’s move was “a good thing.”

“It’s not a be-all, it’s not an end-all,” Isak­son told re­port- ers Tues­day about the move to ex­pand as­so­ci­a­tion health plans. “But it’s a her­culean step for­ward to get some more af­ford­able health care for peo­ple that don’t have any ac­cess to it now.”

Other health care stake­hold­ers in Ge­or­gia were more cau­tious.

Ethan James, the ex­ec­u­tive vice pres­i­dent of ex­ter- nal af­fairs for the Ge­or­gia Hos­pi­tal As­so­ci­a­tion, warned that the changes could en­tice younger, health­ier cus­tomers to switch away from cov­er­age on the Oba m acare ex­changes. That could harm the older, sicker cus­tomers who would re­main on the in­di­vid­ual mar­ket be­cause there would not be enough healthy peo­ple to bal­ance out the risk for in­sur­ers.

“We have to be cau­tious be­cause every ac­tion has an op­po­site re­ac­tion,” he said. “So while we sup­port af­ford­able health care op­tions for con­sumers, if you’re only ad­dress­ing one side of the equa­tion and not the en­tirety of the is­sue, cer­tainly that ef­fect of in­creas­ing costs for the other side of the pop­u­la­tion is of great con­cern for us.”

Ge­or­gia State Univer­sity pro­fes­sor and health care ex­pert Bill Custer said as­so­ci­a­tion plans in the past were laden with many of the prob- lems Obamacare has been try­ing to cor­rect.

“In­di­vid­u­als with pre-ex­ist­ing con­di­tions were charged higher pre­mi­ums to the point it was un­af­ford­able,” he said, which led to in­sur­ers of­fer- ing less cov­er­age. The asso- cia­tion plans, Custer added, “of­ten were not funded suffi- ciently to stay sol­vent when claims needed to be paid.”

No con­crete num­bers were im­me­di­ately avail­able Thurs­day af­ter­noon de­tail­ing how many Ge­or­gians are cur- rently on as­so­ci­a­tion health plans.

Mean­while, Laura Col­bert, the ex­ec­u­tive direc­tor of Ge­or­gians for a Healthy Fu­ture, also took is­sue with Trump’s move to ex­pand ac­cess to short­term health in­sur­ance plans. Sim­i­lar to as­so­ci­a­tion health plans, ex­tend­ing shorter-term op­tions could at­tract healthy pa­tients and lead to in­creased pre­mi­ums for sicker Ge­or­gians on the Obamacare ex­changes, she said.

And such short-term plans, Col­bert added, tend to be skimpier and don’t in­clude lim­its on out-of-pocket costs such as co-pays and de­duc- tions.

“That means that Geor- gi­ans who en­roll in these plans may find them­selves with min­i­mal cov­er­age that ex­cludes the health ser­vices they need and very high, un­ex­pected costs,” she said.

Pro­po­nents touted the as­so­ci­a­tion health plans por-tion of the rule for al­low­ing con­sumers to buy in­sur­ance across state lines, long a pri­or­ity of con­ser­va­tives.

Ge­or­gia has a law on the books that al­lows in­sur­ers to sell across state lines, but no in­surer has taken ad­van­tage be­cause the statute does not pro­vide them with sig­nif­i­cant ad­van­tage over ex­ist­ing health care plans to draw cus­tomers, Custer said.

Health care ex­perts said the de­tails of the new reg­u­la­tions will de­ter­mine whether Trump’s push will be suc­cess­ful, since such as­so­ci­a­tion health plans have been dif­fi­cult to ad­min­is­ter in the past.

Trump’s moves come two weeks af­ter sen­a­tors were forced to aban­don their last­ditch Obamacare re­peal plan due to lack of sup­port. The pres­i­dent has vowed to act uni­lat­er­ally to undo the 2010 law.

“To­day is only the be­gin­ning,” Trump said Thurs­day. “In the com­ing months, we plan to take new mea­sures to pro­vide our peo­ple with even more re­lief and more free­dom.”

U.S. Rep. Buddy Carter, R-Pooler, said in a pre­pared state­ment that he “would have pre­ferred these moves come from Congress,” but that he was “grate­ful Pres­i­dent Trump acted to­day to de­liver re­lief to Amer­i­cans suf­fer­ing un­der Obamacare.”

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