U.S. Chamber Staff


June 13, 2019


One of the most challenging tasks for small business owners is navigating the complexity of health insurance options to offer employees. In fact, our most recent small business survey confirmed that this issue remains a penultimate problem. From considering premiums and deductibles to evaluating the size of provider networks, small businesses have a lot to consider. At the end of the day, regardless of plan’s specifics, many small employers are unable to find, much less offer, affordable health care coverage.

To give small business owners more health care options for their employees, the U.S. Chamber of Commerce has long supported the policy of allowing small businesses to band together to purchase coverage through Association Health Plans (AHPs), which permit small businesses to offer their employees the same type of coverage as larger companies. Just last June, the administration finalized regulations to provide this lifeboat to small businesses drowning in the search for affordable coverage amid the failing small group market. As a result, new AHPs enabled small businesses and self-employed Americans to band together by industry or geography to purchase affordable health coverage to cover their employees.

However, a mere nine months after the regulation was finalized, the DC District Court found in favor of Attorneys General from 11 states and D.C. and declared the bulk of the regulation to be unlawful. The judge agreed with the AGs that the rule would undermine the Affordable Care Act by encouraging individuals to buy cheaper plans with fewer benefits and no consumer protections.

This is simply not true.

To defend this important policy and demonstrate the high value of these plans, the U.S. Chamber of Commerce’s Litigation Center filed an amicus brief on June 7 in support of the AHP regulation in the Circuit Court. We were not alone in our view that AHPs are critically important for small businesses; the National Federation for Independent Business joined the amicus along with 65 state and local chambers from around the country.

For small businesses, the cost of health care coverage can be crippling, which is why so many companies are not able to offer it. The number of small businesses offering health coverage has declined substantially over the years, from 47% in 2000 to 29% in 2016. Unlike bigger companies, who can negotiate for better premium prices, businesses on Main Street are tasked with trying to give their employees flexible insurance options that meet their health care needs while making sure costs don’t break the bank.

This issue seems to be top of mind for many small business owners. The MetLife and U.S. Chamber of Commerce Small Business Index this quarter found that 25% of owners say they do not have enough information to make informed decisions about health insurance options. Additionally, 25% of respondents said keeping premiums low is their top concern when evaluating health care plans.

“The Chamber continues to stand by the new AHP regulation after participating fully in the regulatory notice and comment opportunity. This is an important and comprehensive new coverage option for small businesses,” said Katie Mahoney, vice president of health policy at the U.S. Chamber of Commerce.

The fact of the matter is, AHPs are a way to offer quality health care to employees without bankrupting a small business. Currently, 400,000 uninsured Americans are expected to attain health coverage thanks to the new AHP rule, according to the Congressional Budget Office. They will be among an estimated 4 million Americans expected to purchase new AHPs.

“AHPs are a major step in the right direction for small businesses and the millions of Americans who will now be able to buy lower cost health insurance plans,” said U.S. Chamber CEO Tom Donohue.

About the authors

U.S. Chamber Staff