Thomas J. Donohue Thomas J. Donohue
Advisor and Former Chief Executive Officer, U.S. Chamber of Commerce


April 29, 2019


Last spring, small businesses were given a tremendous opportunity when the Trump administration finalized a rule to expand health care coverage under new Association Health Plans (AHPs). These plans will benefit thousands of America’s workers by allowing small businesses to pool together to access affordable, high-quality health insurance.

But a recent court decision could undo everything.

In March, the U.S. District Court struck down two key provisions of the administration’s AHP rule, putting in jeopardy the health coverage of more than 20,000 Americans. As a result of this decision, small business owners across the country find themselves in legal limbo, wondering what this ruling means for the robust coverage they recently found, purchased, and enjoy.

If small business employees like their existing AHP coverage, they should be able to keep it. That’s why the U.S. Chamber of Commerce will continue to lead the fight for AHPs in the court of law and in the court of public opinion.

AHPs are vital to the success of America’s small businesses. Unlike large corporations, growing companies struggle with the heavy cost of providing health coverage to their employees. But these new AHPs create an opportunity to level the playing field. By allowing small businesses to band together to enroll in a single group health plan, they can cover more people at a lower cost — while providing important consumer protections, such as coverage for individuals with preexisting conditions.

Until last month’s court decision, hundreds of chambers of commerce and other associations were exploring the AHP insurance model. In fact, an estimated 300,000 workers were expected to enroll in these AHPs within the next year. Now, they wait — as do small business owners hoping to enroll in these valuable health plans.

At the U.S. Chamber, we believe in removing barriers that stand between Americans and affordable health coverage. That’s why our policy and legal teams are exploring all options to protect AHPs for the thousands already enrolled, as well as for the hundreds of thousands expected to enroll in the future. In the meantime, we continue to educate and inform through our AHP Database, which serves as a one-stop resource for chambers, businesses, and individuals interested in learning more about new coverage options. A link to the database can be found at

With the many challenges facing our health care system, we need to promote — not eliminate — commonsense solutions like AHPs. This is but one solution among many that we are advancing to expand access to high-quality, affordable health coverage.

About the authors

Thomas J. Donohue

Thomas J. Donohue

Thomas J. Donohue is advisor and former chief executive officer of the U.S. Chamber of Commerce.

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