Katie Mahoney Katie Mahoney
Former Vice President, Health Policy, U.S. Chamber of Commerce


April 03, 2019


The U.S. Chamber of Commerce is disappointed by the recent decision from the U.S. District Court of the District of Columbia which found two core provisions of the Department of Labor’s (DOL) Association Health Plan (AHP) Final Rule unlawful. Dozens of chambers of commerce across the country have launched, or are in the process of launching new Association Health Plans as permitted by the final rule, with over 20,000 individuals currently covered by robust and affordable plans. In addition to the individuals currently covered, dozens of other state and local chambers are in the process of launching a new AHP, and estimate that over 300,000 individuals will obtain coverage through this opportunity in the coming year.

These new AHPs provide robust coverage with a myriad of consumer protections including a ban on excluding individuals based on pre-existing conditions. The U.S. Chamber will continue to work to support this policy in the courts and believe that the decision should be stayed pending the completion of the litigation.

Association Health Plans are helping small businesses

In alignment with the Trump administration’s goal to provide new pathways for affordable and comprehensive health coverage, the Department of Labor’s June 2018 final rule on AHPs has been a welcome first step for millions of small businesses and self-employed individuals across the country. This regulation will allow thousands of small businesses the opportunity to purchase and enroll in robust and affordable health care coverage.

Addressing the concerns of small businesses in rural and urban communities

Small businesses and entrepreneurs are a vital component to the rural regions in which they operate and create an estimated two-thirds of new jobs annually within their communities. However, they are more likely than their urban counterparts to experience higher out of pocket costs for health care due to lack of competition within the marketplace.

In addition, a February 2019 study conducted by Small Business Majority found that rising health care costs were among the top three concerns for rural small business owners. By leveraging this new AHP opportunity, chambers of commerce across the country have begun to shift power back to consumers and provide another choice to individuals who would otherwise struggle to afford coverage.

In urban metropolitan areas, the rising cost of health care further compounds the problem as small businesses are simply not able to keep pace when it comes to recruiting and retaining labor when compared to large employers. Unable to absorb the rising costs of providing health coverage to their employees on the small and individual group markets, AHPs have been a welcome opportunity to level the playing field.

Centralized database for businesses and local chambers of commerce

To assist businesses and local/state chambers of commerce, the U.S. Chamber has created an AHP Database that provides a comprehensive directory of available AHPs for businesses who are looking to join one in their area, as well as a centralized database for associations to list an AHP they offer. In addition, if associations are interested in setting up an AHP of their own, the database includes resources and contact information for legal and benefit experts.

There’s no reason that small businesses and their employees should have less access and choices in coverage options.

Editor's note (4/5/2019): The first paragraph in the section on rural and urban communities was edited for clarity.

About the authors

Katie Mahoney

Katie Mahoney

Katie W. Mahoney is the former vice president of health policy at the U.S. Chamber of Commerce.